Provider Demographics
NPI:1831920628
Name:VALLE DMD, LLC
Entity type:Organization
Organization Name:VALLE DMD, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAILIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:786-752-1385
Mailing Address - Street 1:20210 OLD CUTLER RD
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1919
Mailing Address - Country:US
Mailing Address - Phone:786-752-1385
Mailing Address - Fax:
Practice Address - Street 1:20210 OLD CUTLER RD
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1919
Practice Address - Country:US
Practice Address - Phone:786-752-1385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty