Provider Demographics
NPI:1841412285
Name:SALVADOR, VICTOR (DMD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:SALVADOR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-2207
Mailing Address - Country:US
Mailing Address - Phone:973-812-1234
Mailing Address - Fax:973-812-0679
Practice Address - Street 1:775 UNION BLVD
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-2207
Practice Address - Country:US
Practice Address - Phone:973-812-1234
Practice Address - Fax:973-812-0679
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ161391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice