Provider Demographics
NPI:1972026136
Name:SALAMA, MARY M (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:M
Last Name:SALAMA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13759 AMBLEWIND PL
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46074-8225
Mailing Address - Country:US
Mailing Address - Phone:317-319-8210
Mailing Address - Fax:
Practice Address - Street 1:331 S STATE ROAD 135 STE D
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-1453
Practice Address - Country:US
Practice Address - Phone:317-927-8230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-19
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012783A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice