Healthcare Provider Details

I. General information

NPI: 1366531469
Provider Name (Legal Business Name): NANCY SUE SALISBURY D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 VALE TERRACE DR
VISTA CA
92084-5218
US

IV. Provider business mailing address

42302 OREGON TRL
MURRIETA CA
92562-5229
US

V. Phone/Fax

Practice location:
  • Phone: 760-631-5000
  • Fax:
Mailing address:
  • Phone: 619-922-8841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number52169
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number52169
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: