Individual
DR. ROGER PAUL VALLIERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1330 E STATE BLVD, FORT WAYNE, IN 46805-4422
(260) 484-5614
Mailing address
1330 E STATE BLVD, FORT WAYNE, IN 46805-4422
(260) 484-5614
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12010249A
IN
Other
Enumeration date
07/13/2007
Last updated
06/29/2017
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