Provider Demographics
NPI:1982932844
Name:SALMELA, RICHARD LYLE (DDS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LYLE
Last Name:SALMELA
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 1:18148 MINNETONKA BLVD
Mailing Address - Street 2:
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-3327
Mailing Address - Country:US
Mailing Address - Phone:952-473-9561
Mailing Address - Fax:952-473-7781
Practice Address - Street 1:18148 MINNETONKA BLVD
Practice Address - Street 2:
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-3327
Practice Address - Country:US
Practice Address - Phone:952-473-9561
Practice Address - Fax:952-473-7781
Is Sole Proprietor?:No
Enumeration Date:2009-12-03
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND107951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice