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NPI 1245672476

NPI 1245672476 : ERIC BRETT SALMONSON DDS : SHOREHAM, NY

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General NPI Number Information
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    NPI Number           |    1245672476
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    Entity Type          |    Individual 
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    Provider Name        |    ERIC BRETT SALMONSON DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/30/2013
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    Last Update Date     |    07/30/2013
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Provider Practice Location Address
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    Address Line         |    47 N. COUNTRY RD. 
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    City                 |    SHOREHAM
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    State                |    NY
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    Zip                  |    11786
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    Country              |    US
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    Telephone            |    631-744-0111
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    Fax                  |    631-744-0321
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Provider Business Mailing Address
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    Address Line         |    P.O. BOX 849 47 N. COUNTRY RD.,
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    City                 |    SHOREHAM
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    State                |    NY
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    Zip                  |    11786
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    Country              |    US
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    Telephone            |    631-744-0111
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    Fax                  |    631-744-0321
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    047700-1
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    License Number State |    NY
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