Provider Demographics
NPI:1275780355
Name:SPOTO, SALVADOR (DDS)
Entity Type:Individual
Prefix:DR
First Name:SALVADOR
Middle Name:
Last Name:SPOTO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7807 BAY DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-9726
Mailing Address - Country:US
Mailing Address - Phone:813-814-0062
Mailing Address - Fax:813-814-0062
Practice Address - Street 1:7807 BAY DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-9726
Practice Address - Country:US
Practice Address - Phone:813-814-0062
Practice Address - Fax:813-814-0062
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 4709122300000X
FLDN47091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist