Provider Demographics
NPI:1720312333
Name:ROEL VALADEZ, JR., D.D.S., P.L.L.C.
Entity Type:Organization
Organization Name:ROEL VALADEZ, JR., D.D.S., P.L.L.C.
Other - Org Name:ADVANCED DENTAL CARE OF SOUTH TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VALADEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:361-664-3057
Mailing Address - Street 1:80 N WOODLAWN DR
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-5000
Mailing Address - Country:US
Mailing Address - Phone:361-664-3057
Mailing Address - Fax:361-664-4556
Practice Address - Street 1:80 N WOODLAWN DR
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-5000
Practice Address - Country:US
Practice Address - Phone:361-664-3057
Practice Address - Fax:361-664-4556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty