Provider Demographics
NPI:1538355565
Name:SALDANA, BENJAMIN ROQUE (DDS)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:ROQUE
Last Name:SALDANA
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 1:910 EUCLID AVE
Mailing Address - Street 2:#65
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-3834
Mailing Address - Country:US
Mailing Address - Phone:619-434-3842
Mailing Address - Fax:619-434-3842
Practice Address - Street 1:910 EUCLID AVE
Practice Address - Street 2:#65
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-3834
Practice Address - Country:US
Practice Address - Phone:619-434-3842
Practice Address - Fax:619-434-3842
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA553981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice