Provider Demographics
NPI:1245481498
Name:SALAM, ZEESHAN (DDS)
Entity type:Individual
Prefix:DR
First Name:ZEESHAN
Middle Name:
Last Name:SALAM
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 1:40 FRANKLIN ST STE III
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NY
Mailing Address - Zip Code:13619-1377
Mailing Address - Country:US
Mailing Address - Phone:315-493-1581
Mailing Address - Fax:
Practice Address - Street 1:40 FRANKLIN ST STE III
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:NY
Practice Address - Zip Code:13619-1377
Practice Address - Country:US
Practice Address - Phone:315-493-1581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2014-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0539501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice