Healthcare Provider Details

I. General information

NPI: 1902722796
Provider Name (Legal Business Name): CARMEN PASCUAL VALERO DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 MERCHANTS ROW STE 104
WILLISTON VT
05495-4476
US

IV. Provider business mailing address

62 MERCHANTS ROW STE 104
WILLISTON VT
05495-4476
US

V. Phone/Fax

Practice location:
  • Phone: 802-497-6310
  • Fax:
Mailing address:
  • Phone: 802-497-6310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number016.0134449
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: