Provider Demographics
NPI:1700209517
Name:SPRING VALLEY INC
Entity Type:Organization
Organization Name:SPRING VALLEY INC
Other - Org Name:WHITE SMILE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LABID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-872-0745
Mailing Address - Street 1:80495 US HIGHWAY 111
Mailing Address - Street 2:SUITE D
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-6534
Mailing Address - Country:US
Mailing Address - Phone:714-872-0745
Mailing Address - Fax:951-268-6168
Practice Address - Street 1:80495 US HIGHWAY 111
Practice Address - Street 2:SUITE D
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-6534
Practice Address - Country:US
Practice Address - Phone:714-872-0745
Practice Address - Fax:951-268-6168
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPRING VALLEY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3628750305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service