Provider Demographics
NPI:1679027585
Name:SIGNATURE SMILES DR. SALAMEH, LLC
Entity Type:Organization
Organization Name:SIGNATURE SMILES DR. SALAMEH, LLC
Other - Org Name:SIGNATURE SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAMEH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:330-423-6779
Mailing Address - Street 1:570 CHESTNUT COMMONS DR.
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035
Mailing Address - Country:US
Mailing Address - Phone:330-423-6779
Mailing Address - Fax:
Practice Address - Street 1:570 CHESTNUT COMMONS DR.
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035
Practice Address - Country:US
Practice Address - Phone:330-423-6779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300233121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty