Provider Demographics
NPI:1992893374
Name:VALENCI, JAY A (DMD)
Entity type:Individual
Prefix:MR
First Name:JAY
Middle Name:A
Last Name:VALENCI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 E PHILADELPHIA AVE
Mailing Address - Street 2:
Mailing Address - City:BOYERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19512-1125
Mailing Address - Country:US
Mailing Address - Phone:610-367-1511
Mailing Address - Fax:610-367-1536
Practice Address - Street 1:24 E PHILADELPHIA AVE
Practice Address - Street 2:
Practice Address - City:BOYERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19512-1125
Practice Address - Country:US
Practice Address - Phone:610-367-1511
Practice Address - Fax:610-367-1536
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023479-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice