Provider Demographics
NPI:1255859237
Name:SALAMA DENTAL INC
Entity Type:Organization
Organization Name:SALAMA DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WASFI
Authorized Official - Middle Name:FOUAD
Authorized Official - Last Name:SALAMA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:661-220-0165
Mailing Address - Street 1:3405 MONT BLANC TER
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-7561
Mailing Address - Country:US
Mailing Address - Phone:661-220-0165
Mailing Address - Fax:661-326-8536
Practice Address - Street 1:31093 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-7876
Practice Address - Country:US
Practice Address - Phone:951-457-7330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-30
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD52434261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental