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Individual

WALDO OLIVER VALDIVIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
9554 OLD KEENE MILL RD STE C, BURKE, VA 22015-4287
(703) 952-4003
(571) 281-0001
Mailing address
9554 OLD KEENE MILL RD STE C, BURKE, VA 22015-4287
(703) 952-4003
(571) 281-0001

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
DL12425
MA
1223G0001X
General Practice Dentistry
Primary
0401416353
VA

Other

Enumeration date
10/17/2014
Last updated
10/14/2023
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