Provider Demographics
NPI:1093990236
Name:SALIBA, DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:SALIBA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 COUNTY RD 83
Mailing Address - Street 2:P.O. BOX 322
Mailing Address - City:CANBY
Mailing Address - State:CA
Mailing Address - Zip Code:96015-9702
Mailing Address - Country:US
Mailing Address - Phone:530-233-4641
Mailing Address - Fax:530-233-4140
Practice Address - Street 1:670 COUNTY RD 83
Practice Address - Street 2:
Practice Address - City:CANBY
Practice Address - State:CA
Practice Address - Zip Code:96015-9702
Practice Address - Country:US
Practice Address - Phone:530-233-4641
Practice Address - Fax:530-233-4140
Is Sole Proprietor?:No
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA533301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHM03888FMedicaid