Provider Demographics
NPI:1023335981
Name:SALTER, PAULENE KATHERINE (DDS)
Entity type:Individual
Prefix:DR
First Name:PAULENE
Middle Name:KATHERINE
Last Name:SALTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ROCKY GLN
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92603-3422
Mailing Address - Country:US
Mailing Address - Phone:949-300-3210
Mailing Address - Fax:
Practice Address - Street 1:4040 BARRANCA PKWY
Practice Address - Street 2:STE 135A
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4766
Practice Address - Country:US
Practice Address - Phone:949-262-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-30
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA398811223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics