Provider Demographics
NPI:1154555035
Name:SALMAN, SALAM OMAR (MD, DDS)
Entity type:Individual
Prefix:DR
First Name:SALAM
Middle Name:OMAR
Last Name:SALMAN
Suffix:
Gender:M
Credentials:MD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 PROFESSIONAL CT SE
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-7036
Mailing Address - Country:US
Mailing Address - Phone:706-629-5200
Mailing Address - Fax:
Practice Address - Street 1:117 PROFESSIONAL CT SE
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-7036
Practice Address - Country:US
Practice Address - Phone:706-629-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDTP6181223S0112X
KY87151223S0112X
FLME124338204E00000X
GADN1231701223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery