Provider Demographics
NPI:1386315190
Name:SALVATORE DENTAL PLLC
Entity type:Organization
Organization Name:SALVATORE DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VERA
Authorized Official - Middle Name:POPOVA
Authorized Official - Last Name:SALVATORE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:518-899-6068
Mailing Address - Street 1:127 DUNNING ST
Mailing Address - Street 2:
Mailing Address - City:MALTA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-4406
Mailing Address - Country:US
Mailing Address - Phone:518-899-6068
Mailing Address - Fax:518-899-6069
Practice Address - Street 1:127 DUNNING ST
Practice Address - Street 2:
Practice Address - City:MALTA
Practice Address - State:NY
Practice Address - Zip Code:12020-4406
Practice Address - Country:US
Practice Address - Phone:518-899-6068
Practice Address - Fax:518-899-6069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty