Provider Demographics
NPI:1497027155
Name:DEL MAR DENTAL PLLC
Entity type:Organization
Organization Name:DEL MAR DENTAL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:940-220-4983
Mailing Address - Street 1:1805 HINKLE DR # 100
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-1768
Mailing Address - Country:US
Mailing Address - Phone:940-220-4983
Mailing Address - Fax:940-387-1264
Practice Address - Street 1:7807 MCPHERSON RD
Practice Address - Street 2:SUITE 205
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-2801
Practice Address - Country:US
Practice Address - Phone:940-220-4983
Practice Address - Fax:940-387-1264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX265541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty