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General NPI Number Information
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NPI Number | 1881117398
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Entity Type | Organization
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Legal Business Name | AV DENTAL PLLC
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Dates
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Enumeration Date | 07/18/2017
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Last Update Date | 07/18/2017
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Provider Practice Location Address
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Address Line | 1313 HOLLAND ST STE E
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City | HOUSTON
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State | TX
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Zip | 77029-2873
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Country | US
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Telephone | 281-974-4086
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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 | 713-588-1843
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Authorized Official
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Title or Position | OWNER
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Name | ALICIA P VALENTINI
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Credential | DDS
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Telephone | 281-974-4086
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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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