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General NPI Number Information
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NPI Number | 1720543580
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Entity Type | Organization
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Legal Business Name | GUSTAVO SALAS DDS MS PLLC
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Dates
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Enumeration Date | 02/06/2019
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 2720 N MASON RD
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City | KATY
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State | TX
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Zip | 77449-4143
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Country | US
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Telephone | 713-955-2013
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Fax |
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Provider Business Mailing Address
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Address Line | 2720 N MASON RD
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City | KATY
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State | TX
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Zip | 77449-4143
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Country | US
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Telephone | 713-955-2013
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GUSTAVO SALAS
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Credential | DDS,MS
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Telephone | 713-955-2013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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