Provider Demographics
NPI:1205476207
Name:DRS SALEM AND SOLIMAN DENTAL CORP
Entity type:Organization
Organization Name:DRS SALEM AND SOLIMAN DENTAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:F
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, CEO
Authorized Official - Phone:916-849-3174
Mailing Address - Street 1:1021 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95337-5703
Mailing Address - Country:US
Mailing Address - Phone:209-250-2600
Mailing Address - Fax:209-250-2707
Practice Address - Street 1:1021 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95337-5703
Practice Address - Country:US
Practice Address - Phone:209-250-2600
Practice Address - Fax:209-250-2707
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DRS SALEM AND SOLIMAN DENTAL CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-08
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental