Individual
ALEXIS VALENTINA VIDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
(207) 798-5429
Mailing address
2441 21ST ST, FORT CAMPBELL, KY 42223-5582
(207) 798-5429
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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