Provider Demographics
NPI:1669819330
Name:AL-SALMAN, HAITHAM S (DDS)
Entity Type:Individual
Prefix:DR
First Name:HAITHAM
Middle Name:S
Last Name:AL-SALMAN
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 1:2960 INTERSTATE 45 N STE 300
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77303-7912
Mailing Address - Country:US
Mailing Address - Phone:936-314-2688
Mailing Address - Fax:
Practice Address - Street 1:2960 INTERSTATE 45 N STE 300
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77303-7912
Practice Address - Country:US
Practice Address - Phone:936-314-2688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-04
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29019122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist