Provider Demographics
NPI:1679673040
Name:RGV SMILES BY ROCKY L. SALINAS D.D.S. P.A.
Entity type:Organization
Organization Name:RGV SMILES BY ROCKY L. SALINAS D.D.S. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROCKY
Authorized Official - Middle Name:L
Authorized Official - Last Name:SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-283-7919
Mailing Address - Street 1:805 N CAGE BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-3109
Mailing Address - Country:US
Mailing Address - Phone:956-283-7919
Mailing Address - Fax:956-283-7886
Practice Address - Street 1:805 N CAGE BLVD STE D
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-3109
Practice Address - Country:US
Practice Address - Phone:956-283-7919
Practice Address - Fax:956-283-7886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG6048401OtherCHIPS
TX189253101Medicaid