Provider Demographics
NPI:1700880275
Name:SALON, JOEL MARC (DDS,MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:MARC
Last Name:SALON
Suffix:
Gender:M
Credentials:DDS,MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:34501 AURORA RD
Mailing Address - Street 2:STE 301
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-3831
Mailing Address - Country:US
Mailing Address - Phone:440-248-9097
Mailing Address - Fax:440-248-9099
Practice Address - Street 1:34501 AURORA RD
Practice Address - Street 2:STE 301
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-3831
Practice Address - Country:US
Practice Address - Phone:440-248-9097
Practice Address - Fax:440-248-9099
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-01-52471223S0112X
OH35-04-7600-S204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Not Answered204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery