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General NPI Number Information
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NPI Number | 1952572919
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Entity Type | Organization
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Legal Business Name | BRETT ALAN VALENTINE D.M.D.
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 07/01/2008
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Provider Practice Location Address
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Address Line | 4864-B HWY 589
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City | SUMRALL
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State | MS
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Zip | 39482
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Country | US
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Telephone | 601-758-0150
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Fax | 601-758-0149
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Provider Business Mailing Address
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Address Line | 4864-B HWY 589
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City | SUMRALL
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State | MS
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Zip | 39482
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Country | US
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Telephone | 601-758-0150
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Fax | 601-758-0149
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRETT A. VALENTINE
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Credential | D.M.D.
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Telephone | 601-758-0150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2752-93
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License Number State | MS
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