Individual
DR. JEFFREY PAUL VALLIERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1330 E STATE BLVD, FORT WAYNE, IN 46805-4422
(260) 484-5614
Mailing address
1330 E STATE BLVD, FORT WAYNE, IN 46805-4422
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12012713A
IN
Other
Enumeration date
06/13/2017
Last updated
01/19/2022
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