MEDICARE: DR. EUGENIO DOMINGUEZ SALVANERA DMD

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	B35828	CA

General Provider Information

NPI Number	:	1881721058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EUGENIO DOMINGUEZ SALVANERA DMD

Provider Business Mailing Address
First Line	:	1035 S HARBISON AVE
Second Line	:	SUITE A
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-3919
Country	:	US
Telephone Number	:	619-472-0400
Fax Number	:	619-475-2369

Provider Business Practice Location Address
First Line	:	1035 S HARBISON AVE
Second Line	:	SUITE A
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-3919
Country	:	US
Telephone Number	:	619-472-0400
Fax Number	:	619-475-2369

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

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	09/08/2020

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