Provider Demographics
NPI:1447728365
Name:VALLEY DENTAL CARE
Entity type:Organization
Organization Name:VALLEY DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:AYMAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:ADEEB
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-645-6576
Mailing Address - Street 1:10007 JEFFERSON DAVIS HWY STE 125
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-9428
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10007 JEFFERSON DAVIS HWY STE 125
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-9428
Practice Address - Country:US
Practice Address - Phone:540-645-6576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1467749127OtherGENERAL DENTIST