Provider Demographics
NPI:1275602757
Name:SALMON, TREVOR LENWORTH (DDS)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:LENWORTH
Last Name:SALMON
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 1:6505 BELCREST RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-2011
Mailing Address - Country:US
Mailing Address - Phone:301-559-5435
Mailing Address - Fax:301-559-4393
Practice Address - Street 1:6505 BELCREST RD
Practice Address - Street 2:SUITE 105
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-2011
Practice Address - Country:US
Practice Address - Phone:301-559-5435
Practice Address - Fax:301-559-4393
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN166031223G0001X
MD91361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice