Provider Demographics
NPI:1699917435
Name:VALENTE, LOUIS JOHN (DMD, MD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:JOHN
Last Name:VALENTE
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 HAMPTON CIR
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29909-5015
Mailing Address - Country:US
Mailing Address - Phone:843-705-7235
Mailing Address - Fax:843-705-7235
Practice Address - Street 1:157 HAMPTON CIR
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29909-5015
Practice Address - Country:US
Practice Address - Phone:843-705-7235
Practice Address - Fax:843-705-7235
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9909122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist