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General NPI Number Information
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NPI Number | 1538879408
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Entity Type | Organization
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Legal Business Name | VALENTINI GRAS DENTAL PLLC
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Dates
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Enumeration Date | 12/01/2022
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Last Update Date | 12/07/2022
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Provider Practice Location Address
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Address Line | 4718 INGERSOLL ST
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City | HOUSTON
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State | TX
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Zip | 77027-6602
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Country | US
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Telephone | 832-763-3185
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Fax |
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Provider Business Mailing Address
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Address Line | 650 HEIGHTS BLVD
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City | HOUSTON
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State | TX
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Zip | 77007-2524
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Country | US
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Telephone | 281-974-4086
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MISS YASMIN MEDELLIN
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Credential | RDA
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Telephone | 832-763-3185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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