Provider Demographics
NPI:1942939137
Name:SAMY SALHADAR DDS PLLC
Entity Type:Organization
Organization Name:SAMY SALHADAR DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SALHADAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:616-676-2223
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-0158
Mailing Address - Country:US
Mailing Address - Phone:616-780-0538
Mailing Address - Fax:
Practice Address - Street 1:7210 HEADLEY ST SE
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:MI
Practice Address - Zip Code:49301-9786
Practice Address - Country:US
Practice Address - Phone:616-780-0538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty