Provider Demographics
NPI:1639532641
Name:SALEM DENTAL ARTS
Entity Type:Organization
Organization Name:SALEM DENTAL ARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROSTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MARAGLIANO-MUNIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-741-1640
Mailing Address - Street 1:20 CENTRAL ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3739
Mailing Address - Country:US
Mailing Address - Phone:978-741-1640
Mailing Address - Fax:978-741-0024
Practice Address - Street 1:20 CENTRAL ST
Practice Address - Street 2:SUITE 111
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-3739
Practice Address - Country:US
Practice Address - Phone:978-741-1640
Practice Address - Fax:978-741-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN222991223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty