Provider Demographics
NPI:1942432190
Name:AQIL, SALIM MOHAMMAD (DDS)
Entity Type:Individual
Prefix:DR
First Name:SALIM
Middle Name:MOHAMMAD
Last Name:AQIL
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 1:6540 REFLECTION DR
Mailing Address - Street 2:UNIT # 1227
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-5119
Mailing Address - Country:US
Mailing Address - Phone:714-926-8322
Mailing Address - Fax:
Practice Address - Street 1:1 BOONE RD
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312
Practice Address - Country:US
Practice Address - Phone:360-475-4806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-20
Last Update Date:2019-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA598741223X0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0008XDental ProvidersDentistOral and Maxillofacial Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program