Individual
GUSTAVO A. TEVES SALAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
13341 SW 110TH TER, MIAMI, FL 33186-4351
(305) 510-1987
Mailing address
13341 SW 110TH TER, MIAMI, FL 33186-4351
(305) 510-1987
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
60114
CA
Other
Enumeration date
02/01/2011
Last updated
02/01/2011
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