Provider Demographics
NPI:1093093247
Name:EMECHETE, VALENTINE C (DENTIST)
Entity Type:Individual
Prefix:
First Name:VALENTINE
Middle Name:C
Last Name:EMECHETE
Suffix:
Gender:M
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 669
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:AR
Mailing Address - Zip Code:72360-0669
Mailing Address - Country:US
Mailing Address - Phone:870-295-5225
Mailing Address - Fax:870-295-6900
Practice Address - Street 1:530 WEST ATKINS BLVD
Practice Address - Street 2:
Practice Address - City:MRIANNA
Practice Address - State:AR
Practice Address - Zip Code:72360
Practice Address - Country:US
Practice Address - Phone:870-295-5225
Practice Address - Fax:870-295-6900
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR3828122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist