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General NPI Number Information
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NPI Number | 1538639539
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Entity Type | Organization
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Legal Business Name | ALISO DENTAL CARE DENTAL GROUP OF SILVIA VALLIS
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Dates
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Enumeration Date | 12/03/2018
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Last Update Date | 12/03/2018
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Provider Practice Location Address
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Address Line | 15 MAREBLU STE 380
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3047
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Country | US
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Telephone | 949-448-0274
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Fax | 949-448-0278
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Provider Business Mailing Address
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Address Line | 15 MAREBLU STE 380
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3047
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Country | US
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Telephone | 949-448-0274
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Fax | 949-448-0278
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Authorized Official
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Title or Position | OWNER
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Name | DR. SILVIA VALLIS
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Credential | DDS
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Telephone | 949-448-0274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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