Healthcare Provider Details
I. General information
NPI: 1508955097
Provider Name (Legal Business Name): CHRISTOPHER ANTHONY SALVO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 WEBB AVE
OLD GREENWICH CT
06870-1512
US
IV. Provider business mailing address
PO BOX 4244
GREENWICH CT
06831-0405
US
V. Phone/Fax
- Phone: 203-637-1141
- Fax:
- Phone: 203-637-1141
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | 4121 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: