Provider Demographics
NPI:1538498571
Name:BROWNSVILLE PEDIATRIC DENTISTRY
Entity Type:Organization
Organization Name:BROWNSVILLE PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:DELGADO
Authorized Official - Last Name:SALCEDO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:210-542-2699
Mailing Address - Street 1:9813 SANDHILL
Mailing Address - Street 2:UNIT 39
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-8872
Mailing Address - Country:US
Mailing Address - Phone:210-542-2699
Mailing Address - Fax:
Practice Address - Street 1:2155 N EXPRESSWAY
Practice Address - Street 2:SUITE H
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-9828
Practice Address - Country:US
Practice Address - Phone:210-315-6405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209831223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty