Provider Demographics
NPI:1265860845
Name:DASSY SALAZAR DMD PC
Entity Type:Organization
Organization Name:DASSY SALAZAR DMD PC
Other - Org Name:COSMETICA DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DASSY
Authorized Official - Middle Name:R
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:713-464-6885
Mailing Address - Street 1:9055 KATY FWY
Mailing Address - Street 2:SUITE 308
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1624
Mailing Address - Country:US
Mailing Address - Phone:713-464-6885
Mailing Address - Fax:832-518-3616
Practice Address - Street 1:9055 KATY FWY
Practice Address - Street 2:SUITE 308
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1624
Practice Address - Country:US
Practice Address - Phone:713-464-6885
Practice Address - Fax:832-518-3616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX135081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty