Provider Demographics
NPI:1396360384
Name:DRS SALEM AND SOLIMAN DENTAL CORP
Entity Type:Organization
Organization Name:DRS SALEM AND SOLIMAN DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:209-573-0879
Mailing Address - Street 1:1021 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-5703
Mailing Address - Country:US
Mailing Address - Phone:209-573-0879
Mailing Address - Fax:
Practice Address - Street 1:2119 E HATCH RD STE BANDC
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95351-4814
Practice Address - Country:US
Practice Address - Phone:209-573-0879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DRS SALEM AND SOLIMAN DENTAL CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty