Provider Demographics
NPI:1609256866
Name:SALAME, NAWAL A (RDH)
Entity Type:Individual
Prefix:MS
First Name:NAWAL
Middle Name:A
Last Name:SALAME
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 114
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-0114
Mailing Address - Country:US
Mailing Address - Phone:313-704-2886
Mailing Address - Fax:
Practice Address - Street 1:2213 N ROSEVERE AVE
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48128-1244
Practice Address - Country:US
Practice Address - Phone:313-704-2886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902010443124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist