Provider Demographics
NPI:1821556184
Name:SALEH, ELLIOT (DMD)
Entity Type:Individual
Prefix:DR
First Name:ELLIOT
Middle Name:
Last Name:SALEH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 MARTINIQUE
Mailing Address - Street 2:
Mailing Address - City:DOLLARD DES ORMEAUX
Mailing Address - State:QUEBEC
Mailing Address - Zip Code:H9G 2Y5
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 EAST 210TH STREET
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-2418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2019-10-23
Deactivation Date:2019-10-16
Deactivation Code:
Reactivation Date:2019-10-23
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program