MEDICARE: RAJIHA K AL SALMAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	015358	MO

General Provider Information

NPI Number	:	1750462339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAJIHA K AL SALMAN DDS

Provider Business Mailing Address
First Line	:	5950 N OAK TRFY STE 103
Second Line	:
City	:	GLADSTONE
State	:	MO
Zip	:	64118-5164
Country	:	US
Telephone Number	:	816-436-5558
Fax Number	:	816-455-5523

Provider Business Practice Location Address
First Line	:	5950 N OAK TRFY STE 103
Second Line	:
City	:	GLADSTONE
State	:	MO
Zip	:	64118-5164
Country	:	US
Telephone Number	:	816-436-5558
Fax Number	:	816-455-5523

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	07/08/2007

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