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Organization
VALLEY DENTAL LLC
Active
Organization
VALLEY DENTAL LLC
Active
Other names
Valley Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MOHIUDDIN IFAZ DMD (OWNER)
(954) 903-8587
Entity
Organization
Contact information
Practice address
10722 KETCHUM VALLEY DR, RIVERVIEW, FL 33579-7185
(813) 671-0675
Mailing address
21662 SNOWY ORCHID TER, LAND O LAKES, FL 34637-4709
(954) 903-8587
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/26/2025
Last updated
08/26/2025
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