Organization
GUSTAVO SALAS DDS MS PLLC
Active
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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