Provider Demographics
NPI:1235262296
Name:HUWAIS, SALAH AL (DDS)
Entity Type:Individual
Prefix:DR
First Name:SALAH
Middle Name:AL
Last Name:HUWAIS
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 1:721 17TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-1409
Mailing Address - Country:US
Mailing Address - Phone:517-782-3607
Mailing Address - Fax:517-782-3658
Practice Address - Street 1:721 17TH ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49203-1409
Practice Address - Country:US
Practice Address - Phone:517-782-3607
Practice Address - Fax:517-782-3658
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010171281223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics