MEDICARE: DR. MARITZA SANCHEZ-SALAZAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	4972	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396740155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARITZA SANCHEZ-SALAZAR

Provider Business Mailing Address
First Line	:	1578 N HWY 89 STE 1
Second Line	:
City	:	CHINO VALLEY
State	:	AZ
Zip	:	86323-7624
Country	:	US
Telephone Number	:	928-237-4061
Fax Number	:

Provider Business Practice Location Address
First Line	:	1578 N HWY 89 STE 1
Second Line	:
City	:	CHINO VALLEY
State	:	AZ
Zip	:	86323-7624
Country	:	US
Telephone Number	:	928-237-4061
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	09/15/2020

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