Provider Demographics
NPI:1538535620
Name:FIGUEROA-VALLE, OMAR (DDS)
Entity type:Individual
Prefix:
First Name:OMAR
Middle Name:
Last Name:FIGUEROA-VALLE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1494 W WADE HAMPTON BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-1166
Mailing Address - Country:US
Mailing Address - Phone:864-655-5870
Mailing Address - Fax:864-655-5874
Practice Address - Street 1:1494 W WADE HAMPTON BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-1166
Practice Address - Country:US
Practice Address - Phone:864-655-5870
Practice Address - Fax:864-655-5874
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8628122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist