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General NPI Number Information
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NPI Number | 1336407410
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Entity Type | Organization
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Legal Business Name | MARIA LUISA C. VALES, D.M.D., INC.
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Dates
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Enumeration Date | 04/26/2012
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Last Update Date | 04/26/2012
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Provider Practice Location Address
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Address Line | 88 E BONITA RD STE F
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City | CHULA VISTA
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State | CA
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Zip | 91910-3057
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Country | US
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Telephone | 619-427-2646
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Fax | 619-427-2642
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Provider Business Mailing Address
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Address Line | 88 E BONITA RD STE F
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City | CHULA VISTA
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State | CA
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Zip | 91910-3057
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Country | US
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Telephone | 619-427-2646
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Fax | 619-427-2642
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MARIA LUISA C. VALES
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Credential | D.M.D.
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Telephone | 619-427-2646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 43262
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License Number State | CA
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