Provider Demographics
NPI:1356071120
Name:SALEEM, SIJAL (DMD)
Entity Type:Individual
Prefix:DR
First Name:SIJAL
Middle Name:
Last Name:SALEEM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CROSSROADS LN
Mailing Address - Street 2:
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2049
Mailing Address - Country:US
Mailing Address - Phone:860-817-4756
Mailing Address - Fax:
Practice Address - Street 1:141 HEBRON AVE STE 3
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4200
Practice Address - Country:US
Practice Address - Phone:412-648-6080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT13736122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist