Provider Demographics
NPI:1881721058
Name:SALVANERA, EUGENIO DOMINGUEZ (DMD)
Entity type:Individual
Prefix:DR
First Name:EUGENIO
Middle Name:DOMINGUEZ
Last Name:SALVANERA
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 1:1035 S HARBISON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-3919
Mailing Address - Country:US
Mailing Address - Phone:619-472-0400
Mailing Address - Fax:619-475-2369
Practice Address - Street 1:1035 S HARBISON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-3919
Practice Address - Country:US
Practice Address - Phone:619-472-0400
Practice Address - Fax:619-475-2369
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB358281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice