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NPI 1952401788

NPI 1952401788 : LISA B VALINS DMD : FLUSHING, NY

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General NPI Number Information
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    NPI Number           |    1952401788
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    Entity Type          |    Individual 
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    Provider Name        |    LISA B VALINS DMD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/22/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    213-05 UNION TURNPIKE 
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    City                 |    FLUSHING
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    State                |    NY
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    Zip                  |    11364-3593
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    Country              |    US
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    Telephone            |    718-464-0768
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    Fax                  |    718-217-5240
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Provider Business Mailing Address
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    Address Line         |    213-05 UNION TURNPIKE 
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    City                 |    FLUSHING
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    State                |    NY
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    Zip                  |    11364-3593
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    Country              |    US
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    Telephone            |    718-464-0768
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    Fax                  |    718-217-5240
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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        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    044600-1
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    License Number State |    NY
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