Provider Demographics
NPI:1487792347
Name:SALTZ, GARY SCOTT (DDS)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:SCOTT
Last Name:SALTZ
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 1:10626 PARAMOUNT BL
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3323
Mailing Address - Country:US
Mailing Address - Phone:562-861-7234
Mailing Address - Fax:
Practice Address - Street 1:1243 7TH ST
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-1605
Practice Address - Country:US
Practice Address - Phone:310-451-5748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2317421223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics