Provider Demographics
NPI:1790061232
Name:HORIZON DENTAL GROUP
Entity Type:Organization
Organization Name:HORIZON DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAMAH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-932-5300
Mailing Address - Street 1:2770 S HIGHLAND AVE
Mailing Address - Street 2:STE 103
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-5412
Mailing Address - Country:US
Mailing Address - Phone:630-932-5300
Mailing Address - Fax:630-932-8650
Practice Address - Street 1:2770 S HIGHLAND AVE
Practice Address - Street 2:STE 103
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5412
Practice Address - Country:US
Practice Address - Phone:630-932-5300
Practice Address - Fax:630-932-8650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty