Provider Demographics
NPI:1164561809
Name:VALANCIUS & SALVADOR, P.A.
Entity Type:Organization
Organization Name:VALANCIUS & SALVADOR, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:VALANCIUS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:813-963-1724
Mailing Address - Street 1:11013 N DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-3801
Mailing Address - Country:US
Mailing Address - Phone:813-963-1724
Mailing Address - Fax:813-962-2410
Practice Address - Street 1:11013 N DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-3801
Practice Address - Country:US
Practice Address - Phone:813-963-1724
Practice Address - Fax:813-962-2410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN97481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty