Provider Demographics
NPI:1275568941
Name:VALLE, MARK S (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:S
Last Name:VALLE
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 W CENTRAL ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-3188
Mailing Address - Country:US
Mailing Address - Phone:508-528-8808
Mailing Address - Fax:
Practice Address - Street 1:835 W CENTRAL ST
Practice Address - Street 2:SUITE C
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038-3188
Practice Address - Country:US
Practice Address - Phone:508-528-8808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA151811223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics