Provider Demographics
NPI:1083778146
Name:SALINAS, MARIA A (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:A
Last Name:SALINAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:CARDOVA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:159 WENTWORTH STREET
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-1731
Mailing Address - Country:US
Mailing Address - Phone:843-577-2898
Mailing Address - Fax:843-577-4464
Practice Address - Street 1:159 WENTWORTH STREET
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1731
Practice Address - Country:US
Practice Address - Phone:843-577-2898
Practice Address - Fax:843-577-4464
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2787122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZ27873Medicaid
733328OtherUNITED CONCORDIA