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General NPI Number Information
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NPI Number | 1497108484
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Entity Type | Organization
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Legal Business Name | VALLEY DENTAL OUTREACH PLLC
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 07/15/2016
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Provider Practice Location Address
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Address Line | 2605 W MILE 5 RD BUILDING E, SUITE 1
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City | MISSION
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State | TX
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Zip | 78574-0968
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Country | US
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Telephone | 956-391-1103
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Fax |
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Provider Business Mailing Address
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Address Line | 7807 MCPHERSON RD SUITE 205
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City | LAREDO
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State | TX
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Zip | 78045-2813
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Country | US
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Telephone | 956-267-8502
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Fax | 956-267-8498
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Authorized Official
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Title or Position | MANAGER
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Name | DR. AARON MICHAEL SALINAS
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Credential | DDS
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Telephone | 956-612-8062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 26554
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License Number State | TX
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