# QD 775 UNION BLVD., LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982663639
- **Authorized official:** DR. VICTOR SALVADOR DMD (OWNER)
- **Authorized official phone:** (973) 812-1234

## Contact information

- **Practice address:** 775 UNION BLVD, TOTOWA, NJ 07512-2207
- **Practice address phone:** (973) 812-1234
- **Practice address fax:** (973) 812-0679
- **Mailing address:** 775 UNION BLVD, TOTOWA, NJ 07512-2207
- **Mailing address phone:** (973) 812-1234
- **Mailing address fax:** (973) 812-0679

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 15934 | NJ | Yes |
| 1223G0001X | General Practice Dentistry | 16139 | NJ | — |

## Other

- **Enumeration date:** 03/21/2006
- **Last updated:** 08/22/2020