Provider Demographics
NPI:1306278510
Name:VALLDERUTEN, ALMA (DDS)
Entity type:Individual
Prefix:DR
First Name:ALMA
Middle Name:
Last Name:VALLDERUTEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4640 N FEDERAL HWY STE H
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-5205
Mailing Address - Country:US
Mailing Address - Phone:954-491-5748
Mailing Address - Fax:954-491-1883
Practice Address - Street 1:4640 N FEDERAL HWY STE H
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-5205
Practice Address - Country:US
Practice Address - Phone:954-491-5748
Practice Address - Fax:954-491-1883
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN202731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice