MEDICARE: ALFONSO SALAZAR DDS PLLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1649812892
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALFONSO SALAZAR DDS PLLC

Provider Business Mailing Address
First Line	:	1700 S CHAMBERS RD
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80017-5023
Country	:	US
Telephone Number	:	303-369-7272
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 S CHAMBERS RD
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80017-5023
Country	:	US
Telephone Number	:	303-369-7272
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. PATRICIA ELENA MERINO
Credential	:	DDS
Telephone Number	:	720-290-7766

Provider Enumeration Date	:	10/09/2019
Last Update Date	:	10/09/2019

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