Provider Demographics
NPI:1790808137
Name:VALDES, JUAN CESAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:CESAR
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 1:900 N FEDERAL HWY
Mailing Address - Street 2:SUITE 308
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2546
Mailing Address - Country:US
Mailing Address - Phone:954-454-0959
Mailing Address - Fax:
Practice Address - Street 1:900 N FEDERAL HWY
Practice Address - Street 2:SUITE 308
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2546
Practice Address - Country:US
Practice Address - Phone:954-454-0959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN162271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice