Organization
VALDAS CHILDRENS DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDUARDO VALDA (OWNER)
(505) 870-6128
Entity
Organization
Contact information
Practice address
107 W GREEN ST, GALLUP, NM 87301-6241
(505) 870-6128
Mailing address
1401 LINDA DR, GALLUP, NM 87301-5615
(505) 870-6128
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DD2150
NM
1223P0221X
Pediatric Dentistry
DD2159
NM
Other
Enumeration date
05/08/2007
Last updated
08/22/2020
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