Organization
NATALIA VALDERRAMA, DDS, PA
Active
Other names
Valderrama Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATALIA VALDERRAMA DOUGHERTY DDS, MS (PRESIDENT/OWNER)
(904) 434-7783
Entity
Organization
Contact information
Practice address
903 JORDAN BLASS DR STE 102, MELBOURNE, FL 32940-1325
(321) 544-4127
Mailing address
976 WILDWOOD DR, MELBOURNE, FL 32940-1506
(904) 434-7783
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN19651
FL
261QD0000X
Dental Clinic/Center
DN19651
FL
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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