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General NPI Number Information
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NPI Number | 1427208214
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Entity Type | Organization
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Legal Business Name | SALAZAR DENTAL OF INDIANA INC
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 03/03/2021
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Provider Practice Location Address
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Address Line | 2001 W WASHINGTON ST SUITE B2
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City | INDIANAPOLIS
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State | IN
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Zip | 46222-4299
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Country | US
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Telephone | 317-636-2002
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Fax | 317-803-3327
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Provider Business Mailing Address
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Address Line | 2001 W WASHINGTON ST SUITE B2
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City | INDIANAPOLIS
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State | IN
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Zip | 46222-4299
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Country | US
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Telephone | 317-636-2002
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Fax | 317-803-3327
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARTIN R SALAZAR
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Credential |
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Telephone | 317-363-4760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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