Provider Demographics
NPI:1043375637
Name:SALCIDO, ALFRED RICHARD (DDS)
Entity type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:RICHARD
Last Name:SALCIDO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 S HACIENDA BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-6305
Mailing Address - Country:US
Mailing Address - Phone:626-968-8573
Mailing Address - Fax:626-330-4617
Practice Address - Street 1:3120 S HACIENDA BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-6305
Practice Address - Country:US
Practice Address - Phone:626-968-8573
Practice Address - Fax:626-330-4617
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD-210571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice