Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 39881 | CA |
NPI | 1023335981 |
---|---|
Provider Name | Dr. Paulene Katherine Salter |
First Address | Irvine, CA 92603-3422 |
Second Address | Irvine, CA 92604-4766 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2010 |
Last Update Date | 30/04/2010 |