Provider Demographics
NPI:1093884397
Name:SALIB, MOURID MICHAEL (DDS MS PC)
Entity Type:Individual
Prefix:DR
First Name:MOURID
Middle Name:MICHAEL
Last Name:SALIB
Suffix:
Gender:M
Credentials:DDS MS PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N HICKS RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067
Mailing Address - Country:US
Mailing Address - Phone:847-991-5055
Mailing Address - Fax:847-991-5093
Practice Address - Street 1:500 N HICKS RD
Practice Address - Street 2:SUITE 230
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067
Practice Address - Country:US
Practice Address - Phone:847-991-5055
Practice Address - Fax:847-991-5093
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist