Provider Demographics
NPI:1073733655
Name:VILLAR, ANAMARIA (DDS)
Entity Type:Individual
Prefix:MRS
First Name:ANAMARIA
Middle Name:
Last Name:VILLAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:ANAMARIA
Other - Middle Name:
Other - Last Name:BETTERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:5236 EWING AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410-2009
Mailing Address - Country:US
Mailing Address - Phone:612-584-4751
Mailing Address - Fax:
Practice Address - Street 1:17821 HIGHWAY 7 STE 2F
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-4113
Practice Address - Country:US
Practice Address - Phone:952-474-5622
Practice Address - Fax:952-474-0283
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND123451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice