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General NPI Number Information
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NPI Number | 1275017337
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Entity Type | Organization
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Legal Business Name | SALAR AND DELISLE LLC
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Dates
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Enumeration Date | 09/24/2018
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Last Update Date | 09/24/2018
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Provider Practice Location Address
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Address Line | 75 MOUNT ROSE ST STE A
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City | RENO
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State | NV
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Zip | 89509-3426
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Country | US
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Telephone | 775-971-4252
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Fax |
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Provider Business Mailing Address
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Address Line | 75 MOUNT ROSE ST STE A
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City | RENO
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State | NV
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Zip | 89509-3426
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Country | US
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Telephone | 775-971-4252
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | BEHNAM SALAR
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Credential | DMD
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Telephone | 310-968-0562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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