Provider Demographics
NPI:1669838579
Name:VALLEY DENTAL CARE
Entity Type:Organization
Organization Name:VALLEY DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AYMAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:ADEEB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-631-1515
Mailing Address - Street 1:840 N. SHENANDOAH AVE
Mailing Address - Street 2:#1
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630
Mailing Address - Country:US
Mailing Address - Phone:540-631-1515
Mailing Address - Fax:540-431-2728
Practice Address - Street 1:842 N. SHENANDOAH AVE.
Practice Address - Street 2:1
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630
Practice Address - Country:US
Practice Address - Phone:540-631-1515
Practice Address - Fax:540-431-2728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401413285261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental