Provider Demographics
NPI:1093805491
Name:SALEM, MUNAL S (DMD)
Entity Type:Individual
Prefix:MR
First Name:MUNAL
Middle Name:S
Last Name:SALEM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 EAST CENTRAL STREET
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038
Mailing Address - Country:US
Mailing Address - Phone:508-528-0200
Mailing Address - Fax:508-528-2231
Practice Address - Street 1:260 EAST CENTRAL STREET
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:MA
Practice Address - Zip Code:02038
Practice Address - Country:US
Practice Address - Phone:508-528-0200
Practice Address - Fax:508-528-2231
Is Sole Proprietor?:No
Enumeration Date:2006-10-14
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19828122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist