Healthcare Provider Details

I. General information

NPI: 1679673040
Provider Name (Legal Business Name): RGV SMILES BY ROCKY L. SALINAS D.D.S. P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 N CAGE BLVD STE D
PHARR TX
78577-3109
US

IV. Provider business mailing address

805 N CAGE BLVD STE D
PHARR TX
78577-3109
US

V. Phone/Fax

Practice location:
  • Phone: 956-283-7919
  • Fax: 956-283-7886
Mailing address:
  • Phone: 956-283-7919
  • Fax: 956-283-7886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ROCKY L SALINAS
Title or Position: PRESIDENT
Credential: DDS
Phone: 956-283-7919