Provider Demographics
NPI:1912118399
Name:SALVADOR, LEYANNE (DMD)
Entity type:Individual
Prefix:DR
First Name:LEYANNE
Middle Name:
Last Name:SALVADOR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:LEYANNE
Other - Middle Name:
Other - Last Name:SALVADOR-BRAVO DMD PA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:6507 CORAL WAY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155
Mailing Address - Country:US
Mailing Address - Phone:305-266-3974
Mailing Address - Fax:305-263-6880
Practice Address - Street 1:6507 CORAL WAY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155
Practice Address - Country:US
Practice Address - Phone:305-266-3974
Practice Address - Fax:305-263-6880
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN164391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice