MEDICARE: DR. ANNA MARIA SALAS DDS, MS

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	18704	TX

General Provider Information

NPI Number	:	1780680785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNA MARIA SALAS DDS, MS

Provider Business Mailing Address
First Line	:	3642 UNIVERSITY BLVD STE 102
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-3360
Country	:	US
Telephone Number	:	713-481-4885
Fax Number	:	713-481-4886

Provider Business Practice Location Address
First Line	:	3642 UNIVERSITY BLVD STE 102
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77005-3360
Country	:	US
Telephone Number	:	713-481-4885
Fax Number	:	713-481-4886

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	07/08/2007

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