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General NPI Number Information
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NPI Number | 1720509284
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Entity Type | Individual
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Provider Name | VALERIA ROA CANAL DDS
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Gender | Female
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Dates
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Enumeration Date | 07/05/2017
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Last Update Date | 07/05/2017
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Provider Practice Location Address
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Address Line | 3411 SW 36TH TER UNIT 1
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City | OCALA
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State | FL
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Zip | 34474-7404
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Country | US
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Telephone | 352-433-0715
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Fax |
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Provider Business Mailing Address
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Address Line | 1430 SOROLLA AVE
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City | CORAL GABLES
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State | FL
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Zip | 33134-3520
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Country | US
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Telephone | 305-458-3609
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN22844
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License Number State | FL
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