Provider Demographics
NPI:1619970605
Name:SALOMON, ALAN PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:PAUL
Last Name:SALOMON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5575 POPLAR AVE
Mailing Address - Street 2:STE 121
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3824
Mailing Address - Country:US
Mailing Address - Phone:901-683-5293
Mailing Address - Fax:901-683-9370
Practice Address - Street 1:5575 POPLAR AVE
Practice Address - Street 2:STE 121
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3824
Practice Address - Country:US
Practice Address - Phone:901-683-5293
Practice Address - Fax:901-683-9370
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS24181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice