Organization
GUSTAVO SALAS DDS MS PLLC
Active
Other names
PORTAL FAMILY DENTISTRY AND ORTHODONTICS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GUSTAVO SALAS DDS,MS (OWNER)
(713) 955-2013
Entity
Organization
Contact information
Practice address
2720 N MASON RD, KATY, TX 77449-4143
(713) 955-2013
Mailing address
2720 N MASON RD, KATY, TX 77449-4143
(713) 955-2013
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2824310-02
—
TX
Enumeration date
02/06/2019
Last updated
02/06/2019
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