Organization
SALAZAR DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA JOSE SALAZAR D.M.D (CEO)
(201) 861-1007
Entity
Organization
Contact information
Practice address
6219 BERGENLINE AVE, 2ND FL, WEST NEW YORK, NJ 07093-1605
(201) 861-1007
Mailing address
6219 BERGENLINE AVE, 2ND FL, WEST NEW YORK, NJ 07093-1605
(201) 861-1007
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI024160
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0243779
—
NJ
Enumeration date
08/24/2011
Last updated
08/24/2011
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