Provider Demographics
NPI:1821184565
Name:SALEM, RAMSEY BADER (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAMSEY
Middle Name:BADER
Last Name:SALEM
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 1:638 QUEENS HARBOUR BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-4928
Mailing Address - Country:US
Mailing Address - Phone:904-221-0892
Mailing Address - Fax:
Practice Address - Street 1:6237 MERRILL ROAD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32277
Practice Address - Country:US
Practice Address - Phone:904-744-2111
Practice Address - Fax:904-743-0035
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0077821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice