Provider Demographics
NPI:1164696480
Name:SALTI, SAMER (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAMER
Middle Name:
Last Name:SALTI
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 1:1201 WEST ESPLANADE AVE
Mailing Address - Street 2:APT 611
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065
Mailing Address - Country:US
Mailing Address - Phone:504-338-2525
Mailing Address - Fax:504-520-8953
Practice Address - Street 1:1201 W ESPLANADE AVE
Practice Address - Street 2:APT 611
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-6246
Practice Address - Country:US
Practice Address - Phone:504-338-2525
Practice Address - Fax:504-520-8953
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAS-4841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice