Provider Demographics
NPI:1740526060
Name:ROCKACY, VALERIE Q (DDS)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:Q
Last Name:ROCKACY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14200 S MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745-8619
Mailing Address - Country:US
Mailing Address - Phone:479-582-0600
Mailing Address - Fax:479-443-4630
Practice Address - Street 1:1607 E RAINFOREST DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5385
Practice Address - Country:US
Practice Address - Phone:479-582-0600
Practice Address - Fax:476-443-4630
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3584122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist