Provider Demographics
NPI:1427751874
Name:MB VALDES DENTIST P.A.
Entity type:Organization
Organization Name:MB VALDES DENTIST P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:786-604-2625
Mailing Address - Street 1:698 N HOMESTEAD BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-6211
Mailing Address - Country:US
Mailing Address - Phone:786-604-2625
Mailing Address - Fax:786-800-2301
Practice Address - Street 1:698 N HOMESTEAD BLVD STE 106
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-6211
Practice Address - Country:US
Practice Address - Phone:786-604-2625
Practice Address - Fax:786-800-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental