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General NPI Number Information
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NPI Number | 1205716057
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Entity Type | Organization
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Legal Business Name | SALEM DENTAL-MT GILEAD LLC
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 889 MEADOW DR
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City | MOUNT GILEAD
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State | OH
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Zip | 43338-1069
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Country | US
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Telephone | 419-947-9547
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Fax |
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Provider Business Mailing Address
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Address Line | 889 MEADOW DR
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City | MOUNT GILEAD
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State | OH
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Zip | 43338-1069
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Country | US
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Telephone | 419-947-9547
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Fax |
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | ALA-EL-DEAN SAMI SALEM
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Credential | DDS
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Telephone | 440-319-9024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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