Organization
MICHAEL VALLARTA DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL VALLARTA D.M.D. (PRESIDENT)
(760) 274-7587
Entity
Organization
Contact information
Practice address
1474 N MILPITAS BLVD, MILPITAS, CA 95035-3118
(408) 946-1397
Mailing address
PO BOX 611382, SAN JOSE, CA 95161-1382
(760) 274-7587
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
56838
CA
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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