Individual
MR. MARK KEKOA VALDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
US ARMY DENTAL ACTIVITY 4431 68TH STREET, FORT HOOD, TX 76544
(254) 287-2705
Mailing address
BLDG 39033 SUPPORT AVE FT, HOOD TX, APO, AA 76544
(808) 430-1508
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H01098950
DENTAL HYGIENIST
HI
Enumeration date
06/27/2016
Last updated
06/27/2016
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