Provider Demographics
NPI:1417977737
Name:MALIK, SALMAN (DMD, MD)
Entity Type:Individual
Prefix:DR
First Name:SALMAN
Middle Name:
Last Name:MALIK
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 NASHUA RD
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3426
Mailing Address - Country:US
Mailing Address - Phone:603-432-3308
Mailing Address - Fax:603-425-6165
Practice Address - Street 1:80 NASHUA RD
Practice Address - Street 2:BUILDING C
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3426
Practice Address - Country:US
Practice Address - Phone:603-432-3308
Practice Address - Fax:603-425-6165
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH30251223S0112X
NY044552-011223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30312701Medicaid
NH020515032OtherTAX ID
NH0206381Y0NH01OtherBLUE CROSS BLUE SHIELD ID
NHRE4702Medicare ID - Type Unspecified