Provider Demographics
NPI:1215086285
Name:VALENTE, RUFOLFO MOORE (DDS)
Entity type:Individual
Prefix:DR
First Name:RUFOLFO
Middle Name:MOORE
Last Name:VALENTE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 MEACHAM AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-3466
Mailing Address - Country:US
Mailing Address - Phone:847-518-2254
Mailing Address - Fax:
Practice Address - Street 1:3430 N OLD ARLINGTON HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1552
Practice Address - Country:US
Practice Address - Phone:847-632-1030
Practice Address - Fax:847-632-1041
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics