Provider Demographics
NPI:1285827709
Name:SALDARRIAGA, JOSE MIGUEL (DDS)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:MIGUEL
Last Name:SALDARRIAGA
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 1:2626 S MOONEY BLVD
Mailing Address - Street 2:STE. A
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-6203
Mailing Address - Country:US
Mailing Address - Phone:559-733-1250
Mailing Address - Fax:559-636-2061
Practice Address - Street 1:2626 S MOONEY BLVD
Practice Address - Street 2:STE. A
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-6203
Practice Address - Country:US
Practice Address - Phone:559-733-1250
Practice Address - Fax:559-636-2061
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA562341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice