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Individual
VALMONT P DESA
Active
Individual
VALMONT P DESA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, DDS
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
5878
NE
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
22875
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47078557585
—
NE
Enumeration date
05/03/2006
Last updated
10/05/2011
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