Provider Demographics
NPI:1255547329
Name:SALVATORE, RICHARD JOSEPH SR (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOSEPH
Last Name:SALVATORE
Suffix:SR
Gender:M
Credentials:DDS
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Mailing Address - Street 1:100 SARATOGA VILLAGE BLVD
Mailing Address - Street 2:SUITE 31B
Mailing Address - City:MALTA
Mailing Address - State:NY
Mailing Address - Zip Code:12020
Mailing Address - Country:US
Mailing Address - Phone:518-899-6068
Mailing Address - Fax:518-899-6069
Practice Address - Street 1:100 SARATOGA VILLAGE BLVD
Practice Address - Street 2:SUITE 31B
Practice Address - City:MALTA
Practice Address - State:NY
Practice Address - Zip Code:12020
Practice Address - Country:US
Practice Address - Phone:518-899-6068
Practice Address - Fax:518-899-6069
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY02916811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice