Individual provider · NPI-1

Salvador Cruz, D.A

Dental Assistant · Lynwood, CA

NPI number1801112164
StatusActive
Last updated in NPPESApr 12, 2010

Details

NPI
1801112164
Entity type
Individual (NPI-1)
Name
Salvador Cruz
Credential
D.A
Sex
Male
Sole proprietor
Yes
Enumeration date
Apr 12, 2010
Last updated
Apr 12, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
126800000X Dental Assistant––Yes

Practice location

9910 Long Beach Blvd
Lynwood, CA 90262-1561

Phone 323-563-8900

Mailing address

3807 Randolph St
Huntington Park, CA 90255-4609

Phone 323-535-9191

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