Provider Demographics
NPI:1477160661
Name:ANTHONY SALEM D.D.S. INC.
Entity Type:Organization
Organization Name:ANTHONY SALEM D.D.S. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-620-3637
Mailing Address - Street 1:3045 SMITH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4449
Mailing Address - Country:US
Mailing Address - Phone:330-668-1165
Mailing Address - Fax:330-668-1165
Practice Address - Street 1:3045 SMITH RD STE 100
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-4449
Practice Address - Country:US
Practice Address - Phone:330-668-1165
Practice Address - Fax:330-668-1169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty