Individual
MR. BRETT A VALENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4864 B HWY 589, SUMRALL, MS 39482
(601) 758-0150
(601) 758-0149
Mailing address
PO BOX 469, SUMRALL, MS 39482
(601) 758-0150
(601) 758-0149
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2752 93
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00660280
—
MS
01
—
873476
UNITED CONCORDIA
—
Enumeration date
09/22/2006
Last updated
04/08/2008
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