NPI 1013116706

Roger Paul Valliere, DDS

Practitioner Dentist Fort Wayne, IN

Practice location

Address: 1330 E State Blvd, Fort Wayne, IN 46805-4422
Phone: (260) 484-5614

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 12010249A (IN)

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Registry record

NPI: 1013116706
Entity type: Individual
Sex (as registered): Male
NPI issued: 13 Jul 2007
Record last updated: 29 Jun 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.