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General NPI Number Information
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NPI Number | 1932722519
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Entity Type | Organization
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Legal Business Name | ROBERTO SALAZAR DENTAL CORPORATION
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Dates
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Enumeration Date | 05/18/2020
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Last Update Date | 07/15/2021
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Provider Practice Location Address
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Address Line | 365 S RANCHO SANTA FE RD STE 105
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City | SAN MARCOS
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State | CA
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Zip | 92078-2338
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Country | US
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Telephone | 760-736-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 W SAN MARCOS BLVD STE 106C
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City | SAN MARCOS
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State | CA
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Zip | 92078-4012
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERTO SALAZAR
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Credential |
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Telephone | 760-525-2997
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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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