Provider Demographics
NPI:1710048202
Name:VALDES, ABELARDO (DDS)
Entity Type:Individual
Prefix:
First Name:ABELARDO
Middle Name:
Last Name:VALDES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5860 W ARIZONA PAVILIONS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-7364
Mailing Address - Country:US
Mailing Address - Phone:520-572-1001
Mailing Address - Fax:520-572-1021
Practice Address - Street 1:5860 W ARIZONA PAVILIONS DR STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85743-7364
Practice Address - Country:US
Practice Address - Phone:520-572-1001
Practice Address - Fax:520-572-1021
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT009242122300000X
AZD009621122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist