Healthcare Provider Details

I. General information

NPI: 1770339004
Provider Name (Legal Business Name): RGV PERIODONTICS AND ORAL SURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2024
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 LORENALY DR STE C
BROWNSVILLE TX
78526-4332
US

IV. Provider business mailing address

302 LORENALY DR STE C
BROWNSVILLE TX
78526-4332
US

V. Phone/Fax

Practice location:
  • Phone: 956-203-0550
  • Fax:
Mailing address:
  • Phone: 956-203-0550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: DR. ARTURO SALINAS JR.
Title or Position: OWNER
Credential: DDS
Phone: 956-203-0550