Provider Demographics
NPI:1972778637
Name:VILLAROSA, THOMAS M (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:M
Last Name:VILLAROSA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:466 POMPTON AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-1812
Mailing Address - Country:US
Mailing Address - Phone:973-857-0567
Mailing Address - Fax:973-239-4456
Practice Address - Street 1:466 POMPTON AVE
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-1812
Practice Address - Country:US
Practice Address - Phone:973-857-0567
Practice Address - Fax:973-239-4456
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01127900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist