Provider Demographics
NPI:1548418460
Name:OMAR SALEM, DMD, MS, PC
Entity Type:Organization
Organization Name:OMAR SALEM, DMD, MS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MSD
Authorized Official - Phone:781-784-6464
Mailing Address - Street 1:450 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-1172
Mailing Address - Country:US
Mailing Address - Phone:781-784-6464
Mailing Address - Fax:781-784-4148
Practice Address - Street 1:450 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067-1172
Practice Address - Country:US
Practice Address - Phone:781-784-6464
Practice Address - Fax:781-784-4148
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OMAR SALEM, DMD, MS, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA213581223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty