Provider Demographics
NPI:1740857010
Name:SALANSKY, GARRETT DILLON (DDS)
Entity type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:DILLON
Last Name:SALANSKY
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 1:856 W 4TH NORTH ST
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-2213
Mailing Address - Country:US
Mailing Address - Phone:423-621-2158
Mailing Address - Fax:423-621-2158
Practice Address - Street 1:856 W 4TH NORTH ST
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3813
Practice Address - Country:US
Practice Address - Phone:423-621-2158
Practice Address - Fax:423-621-2158
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN115901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice