Provider Demographics
NPI:1689941155
Name:SALEM, TERESA MARY (DMD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:MARY
Last Name:SALEM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 PINECREST RD
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-3027
Mailing Address - Country:US
Mailing Address - Phone:781-740-8566
Mailing Address - Fax:
Practice Address - Street 1:175 NORTH FRANKLIN STREET
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:MA
Practice Address - Zip Code:02343
Practice Address - Country:US
Practice Address - Phone:781-767-0979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19021122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist