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General NPI Number Information
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NPI Number | 1083883508
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Entity Type | Organization
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Legal Business Name | GLADYS SALVA CRUZ DDS INC
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | 2314 W KETTLEMAN LN 109
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City | LODI
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State | CA
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Zip | 95242-4126
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Country | US
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Telephone | 209-369-9800
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Fax | 209-369-9800
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Provider Business Mailing Address
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Address Line | 2314 W KETTLEMAN LN 109
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City | LODI
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State | CA
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Zip | 95242-4126
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Country | US
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Telephone | 209-369-9800
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Fax | 209-369-9800
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GLADYS RIVERA SALVA CRUZ
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Credential | DDS
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Telephone | 408-310-3523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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