Individual
DR. DAVID J VALLECORSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4 SUNSET DR, LATHAM, NY 12110-2104
(518) 785-5100
(518) 785-5171
Mailing address
4 SUNSET DR, LATHAM, NY 12110-2104
(518) 785-5100
(518) 785-5171
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
035092
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
035095
STATE LICENCE NUMBER
NY
Enumeration date
09/15/2006
Last updated
09/05/2024
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