Provider Demographics
NPI:1689191181
Name:VILLAFRIA, KRISTINA ANICIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:ANICIA
Last Name:VILLAFRIA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 S BELCHER RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-3713
Mailing Address - Country:US
Mailing Address - Phone:727-535-3233
Mailing Address - Fax:
Practice Address - Street 1:1330 S BELCHER RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-3713
Practice Address - Country:US
Practice Address - Phone:727-535-3233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN229721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice