MEDICARE: DR. CARMEN R SALCEDO 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	1223G0001X	General Practice Dentistry	043079-1	NY

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	:	1699764233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARMEN R SALCEDO D.D.S

Provider Business Mailing Address
First Line	:	78 CRESCENT AVE
Second Line	:
City	:	CLIFFSIDE PARK
State	:	NJ
Zip	:	07010-3046
Country	:	US
Telephone Number	:	201-945-4958
Fax Number	:

Provider Business Practice Location Address
First Line	:	78 CRESCENT AVE
Second Line	:
City	:	CLIFFSIDE PARK
State	:	NJ
Zip	:	07010-3046
Country	:	US
Telephone Number	:	201-945-4958
Fax Number	:

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

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	07/08/2007

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