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NPI Code Detail

MEDICARE: TIMOTHY D VALA D.D.S.

MEDICARE: TIMOTHY D VALA D.D.S.
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
11223G0001XGeneral Practice Dentistry30018045OH

General Provider Information

NPI Number : 1871557611
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY D VALA D.D.S.
Provider Business Mailing Address
First Line : 5539 MAYFIELD RD
Second Line :
City : LYNDHURST
State : OH
Zip : 44124-2913
Country : US
Telephone Number : 440-442-2100
Fax Number : 440-442-4501
Provider Business Practice Location Address
First Line : 5539 MAYFIELD RD
Second Line :
City : LYNDHURST
State : OH
Zip : 44124-2913
Country : US
Telephone Number : 440-442-2100
Fax Number : 440-442-4501
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2006
Last Update Date : 07/08/2007

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Directions to “ TIMOTHY D VALA D.D.S.” Practice Location

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