Provider Demographics
NPI:1851570683
Name:SALKOVITCH, MICHAEL DAVID (DDS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:DAVID
Last Name:SALKOVITCH
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 1:6200 SOM CENTER ROAD
Mailing Address - Street 2:A15
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2900
Mailing Address - Country:US
Mailing Address - Phone:440-914-1960
Mailing Address - Fax:440-914-1962
Practice Address - Street 1:6200 SOM CENTER ROAD
Practice Address - Street 2:A15
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2900
Practice Address - Country:US
Practice Address - Phone:440-914-1960
Practice Address - Fax:440-914-1962
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300144671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice