Provider Demographics
NPI:1114576295
Name:JULIA J VALLE D.D.S., INC.
Entity type:Organization
Organization Name:JULIA J VALLE D.D.S., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-862-5547
Mailing Address - Street 1:1409 WHITLEY AVENUE STE C
Mailing Address - Street 2:
Mailing Address - City:CORCORAN
Mailing Address - State:CA
Mailing Address - Zip Code:93212-2219
Mailing Address - Country:US
Mailing Address - Phone:559-992-2166
Mailing Address - Fax:559-992-3363
Practice Address - Street 1:1409 WHITLEY AVENUE STE C
Practice Address - Street 2:
Practice Address - City:CORCORAN
Practice Address - State:CA
Practice Address - Zip Code:93212-2219
Practice Address - Country:US
Practice Address - Phone:559-992-2166
Practice Address - Fax:559-992-3363
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:-
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-10
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty