Provider Demographics
NPI:1114337458
Name:ROBERT R.VALLEE, P.C.
Entity Type:Organization
Organization Name:ROBERT R.VALLEE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:VALLEE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-366-5646
Mailing Address - Street 1:47 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-1628
Mailing Address - Country:US
Mailing Address - Phone:508-366-5646
Mailing Address - Fax:508-898-9798
Practice Address - Street 1:47 SOUTH ST
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-1628
Practice Address - Country:US
Practice Address - Phone:508-366-5646
Practice Address - Fax:508-898-9798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10178122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty