MEDICARE: WARREN VALLERAND, DDS, MD, PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	WV017431	MI

General Provider Information

NPI Number	:	1376712968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WARREN VALLERAND, DDS, MD, PC

Provider Business Mailing Address
First Line	:	40399 GRAND RIVER AVE
Second Line	:	SUITE 140
City	:	NOVI
State	:	MI
Zip	:	48375-2148
Country	:	US
Telephone Number	:	248-478-7200
Fax Number	:	248-478-7237

Provider Business Practice Location Address
First Line	:	40399 GRAND RIVER AVE
Second Line	:	SUITE 140
City	:	NOVI
State	:	MI
Zip	:	48375-2148
Country	:	US
Telephone Number	:	248-478-7200
Fax Number	:	248-478-7237

Authorized Official
Title or Position	:	SURGEON
Name	:	DR. WARREN P VALLERAND
Credential	:	DDS, MD
Telephone Number	:	248-478-7200

Provider Enumeration Date	:	02/27/2008
Last Update Date	:	02/28/2008

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