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Organization
SALAZAR DENTAL SERIVCES,PA
Active
Organization
SALAZAR DENTAL SERIVCES,PA
Active
Other names
Port Isabel Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SONDRA LEIGH III D.D.S. (PRESIDENT)
(956) 943-4166
Entity
Organization
Contact information
Practice address
215 W QUEEN ISABELLA STE A, PORT ISABEL, TX 78578-2418
(956) 943-4166
Mailing address
PO BOX 1584, PORT ISABEL, TX 78578-1584
(281) 658-5083
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22781
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213930501
—
TX
Enumeration date
07/28/2010
Last updated
06/11/2020
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