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Individual

ENRIQUE SALGADO SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4149 TWEEDY BLVD, SOUTH GATE, CA 90280-6167
(323) 204-0915
Mailing address
4149 TWEEDY BLVD, SOUTH GATE, CA 90280-6167
(323) 204-0915

Taxonomy

Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
69539
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
69539
CA
Enumeration date
03/22/2019
Last updated
03/22/2019
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