Provider Demographics
NPI:1568101194
Name:QURESHI, SALMAN RAHMAT (DMD)
Entity Type:Individual
Prefix:
First Name:SALMAN
Middle Name:RAHMAT
Last Name:QURESHI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48342 LONG LEAF DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-2351
Mailing Address - Country:US
Mailing Address - Phone:586-883-4500
Mailing Address - Fax:
Practice Address - Street 1:1109 W BROAD ST
Practice Address - Street 2:
Practice Address - City:CHESANING
Practice Address - State:MI
Practice Address - Zip Code:48616-1088
Practice Address - Country:US
Practice Address - Phone:989-845-7242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016013821223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral Practice