Provider Demographics
NPI:1235407107
Name:SALIH, SAWSAN MOHAMED (BDS, MPH)
Entity Type:Individual
Prefix:DR
First Name:SAWSAN
Middle Name:MOHAMED
Last Name:SALIH
Suffix:
Gender:F
Credentials:BDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 W REYNOSA AVE
Mailing Address - Street 2:
Mailing Address - City:DE LEON
Mailing Address - State:TX
Mailing Address - Zip Code:76444-1630
Mailing Address - Country:US
Mailing Address - Phone:325-646-0704
Mailing Address - Fax:866-810-6631
Practice Address - Street 1:104 S PARK DR
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5918
Practice Address - Country:US
Practice Address - Phone:325-646-0704
Practice Address - Fax:866-810-6631
Is Sole Proprietor?:No
Enumeration Date:2011-12-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31850122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX366368403Medicaid
TX366368401Medicaid
TX366368402Medicaid