Healthcare Provider Details

I. General information

NPI: 1093075970
Provider Name (Legal Business Name): SALAMA AND ALKHALAYLEH DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2012
Last Update Date: 09/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 CHINA GRADE LOOP
BAKERSFIELD CA
93308-1707
US

IV. Provider business mailing address

201 CHINA GRADE LOOP
BAKERSFIELD CA
93308-1707
US

V. Phone/Fax

Practice location:
  • Phone: 661-393-4333
  • Fax: 661-393-4343
Mailing address:
  • Phone: 661-393-4333
  • Fax: 661-393-4343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. WASFI F SALAMA
Title or Position: OWNER
Credential: DDS
Phone: 661-393-4333