Provider Demographics
NPI:1285951996
Name:OSBORN, VALERIE M (RDH)
Entity type:Individual
Prefix:MS
First Name:VALERIE
Middle Name:M
Last Name:OSBORN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 POTTER VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLTON
Mailing Address - State:MA
Mailing Address - Zip Code:01507-6723
Mailing Address - Country:US
Mailing Address - Phone:617-571-1697
Mailing Address - Fax:
Practice Address - Street 1:27 POTTER VILLAGE RD
Practice Address - Street 2:
Practice Address - City:CHARLTON
Practice Address - State:MA
Practice Address - Zip Code:01507-6723
Practice Address - Country:US
Practice Address - Phone:617-571-1697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13020124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist