Provider Demographics
NPI:1104165026
Name:SALAS, CARLOS (DDS)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:SALAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 E ARAPAHOE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1275
Mailing Address - Country:US
Mailing Address - Phone:303-495-3443
Mailing Address - Fax:303-957-5613
Practice Address - Street 1:7500 E ARAPAHOE RD
Practice Address - Street 2:SUITE 202
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1275
Practice Address - Country:US
Practice Address - Phone:303-495-3443
Practice Address - Fax:303-957-5613
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2019241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice