Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 04014110596 | VA |
NPI | 1073536306 |
---|---|
Provider Name | Trang Salzberg |
First Address | Virginia Beach, VA 23452-7349 |
Second Address | Virginia Beach, VA 23452-7349 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 06/09/2007 |