MEDICARE: DR. GARY SCOTT SALTZ D.D.S.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	231742	CA

General Provider Information

NPI Number	:	1487792347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY SCOTT SALTZ D.D.S.

Provider Business Mailing Address
First Line	:	10626 PARAMOUNT BL
Second Line	:
City	:	DOWNEY
State	:	CA
Zip	:	90241-3323
Country	:	US
Telephone Number	:	562-861-7234
Fax Number	:

Provider Business Practice Location Address
First Line	:	1243 7TH ST
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90401-1605
Country	:	US
Telephone Number	:	310-451-5748
Fax Number	:

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

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	07/08/2007

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