Healthcare Provider Details

I. General information

NPI: 1326882200
Provider Name (Legal Business Name): RAQUEL REYES SALIM DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 STATION LOOP
BLUFFTON SC
29910-9522
US

IV. Provider business mailing address

3280 MITCHELL BLVD
MOODY AFB GA
31699-2040
US

V. Phone/Fax

Practice location:
  • Phone: 843-227-3700
  • Fax:
Mailing address:
  • Phone: 229-257-2778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number10783
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: