Healthcare Provider Details

I. General information

NPI: 1942906839
Provider Name (Legal Business Name): SALEH DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2023
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

576 N SUNRISE AVE STE 130
ROSEVILLE CA
95661-2846
US

IV. Provider business mailing address

576 N SUNRISE AVE STE 130
ROSEVILLE CA
95661-2846
US

V. Phone/Fax

Practice location:
  • Phone: 916-784-3337
  • Fax:
Mailing address:
  • Phone: 916-784-3337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ASHKAN ALIZADEH
Title or Position: PRESIDENT
Credential:
Phone: 916-759-0238