Provider Demographics
NPI:1295851475
Name:SALVADOR, LUISA
Entity Type:Individual
Prefix:DR
First Name:LUISA
Middle Name:
Last Name:SALVADOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2183 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-1351
Mailing Address - Country:US
Mailing Address - Phone:650-364-0888
Mailing Address - Fax:650-364-2888
Practice Address - Street 1:2183 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061-1351
Practice Address - Country:US
Practice Address - Phone:650-364-0888
Practice Address - Fax:650-364-2888
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA481771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice