Individual
BRUCE VALENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1801 TULLY RD, SUITE B, MODESTO, CA 95350-2931
(209) 526-0982
(209) 527-1971
Mailing address
1801 TULLY RD, SUITE B, MODESTO, CA 95350-2931
(209) 526-0982
(209) 527-1971
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
20789
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20789
DENTAL LICENSE
CA
01
—
236914
DENTI-CAL
CA
Enumeration date
06/25/2007
Last updated
07/08/2007
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