Provider Demographics
NPI:1881117398
Name:AV DENTAL PLLC
Entity type:Organization
Organization Name:AV DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:P
Authorized Official - Last Name:VALENTINI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-974-4086
Mailing Address - Street 1:650 HEIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-2524
Mailing Address - Country:US
Mailing Address - Phone:281-974-4086
Mailing Address - Fax:713-588-1843
Practice Address - Street 1:1313 HOLLAND ST STE E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-2873
Practice Address - Country:US
Practice Address - Phone:281-974-4086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty