Provider Demographics
NPI:1497108484
Name:VALLEY DENTAL OUTREACH PLLC
Entity Type:Organization
Organization Name:VALLEY DENTAL OUTREACH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-612-8062
Mailing Address - Street 1:7807 MCPHERSON RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-2813
Mailing Address - Country:US
Mailing Address - Phone:956-267-8502
Mailing Address - Fax:956-267-8498
Practice Address - Street 1:2605 W MILE 5 RD
Practice Address - Street 2:BUILDING E, SUITE 1
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78574-0968
Practice Address - Country:US
Practice Address - Phone:956-391-1103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-14
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX265541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty