Healthcare Provider Details
I. General information
NPI: 1992852206
Provider Name (Legal Business Name): PARALUMAN VALMONTE FAELDAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
16018 AMAR RD
CITY OF INDUSTRY CA
91744
US
IV. Provider business mailing address
16018 AMAR RD
CITY OF INDUSTRY CA
91744
US
V. Phone/Fax
- Phone: 620-333-1882
- Fax: 620-333-1882
- Phone: 620-333-1882
- Fax: 620-333-1882
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | 37993 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: