Provider Demographics
NPI:1659588960
Name:VALLEE, REMY (DMD)
Entity Type:Individual
Prefix:MR
First Name:REMY
Middle Name:
Last Name:VALLEE
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 1:57 OLD ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-2053
Mailing Address - Country:US
Mailing Address - Phone:802-524-0345
Mailing Address - Fax:
Practice Address - Street 1:57 OLD ORCHARD RD
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-2053
Practice Address - Country:US
Practice Address - Phone:802-524-0345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT01600020991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1011179Medicaid
VT119913OtherUNITED CONCORDIA
VT58115OtherBLUE CROSS BLUE SHIELD