Healthcare Provider Details

I. General information

NPI: 1528996907
Provider Name (Legal Business Name): SAUL RODRIGUEZ FLORES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 TERRY AVE UNIT 305
SEATTLE WA
98104-2282
US

IV. Provider business mailing address

520 TERRY AVE UNIT 305
SEATTLE WA
98104-2282
US

V. Phone/Fax

Practice location:
  • Phone: 718-775-2266
  • Fax:
Mailing address:
  • Phone: 718-775-2266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License NumberDEAS.D1.70069097
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: