Healthcare Provider Details

I. General information

NPI: 1962539247
Provider Name (Legal Business Name): VALMY KULBERSH DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 BEAUBIEN ST
DETROIT MI
48201-2119
US

IV. Provider business mailing address

5555 METROPOLITAN PKWY STE 200
STERLING HEIGHTS MI
48310-4102
US

V. Phone/Fax

Practice location:
  • Phone: 313-745-5437
  • Fax:
Mailing address:
  • Phone: 586-268-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901012429
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: