Provider Demographics
NPI:1790169878
Name:SALINA SANCHEZ ASIDERA DDS INC.
Entity Type:Organization
Organization Name:SALINA SANCHEZ ASIDERA DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SALINA
Authorized Official - Middle Name:SANCHEZ
Authorized Official - Last Name:ASIDERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-715-9374
Mailing Address - Street 1:7214 CANOGA AVE
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-1627
Mailing Address - Country:US
Mailing Address - Phone:818-715-9374
Mailing Address - Fax:818-715-9384
Practice Address - Street 1:7214 CANOGA AVE
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1627
Practice Address - Country:US
Practice Address - Phone:818-715-9374
Practice Address - Fax:818-715-9384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55992261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental