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General NPI Number Information
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NPI Number | 1518944172
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Entity Type | Individual
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Provider Name | JERRY W SALO D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/26/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 32 WORCESTER RD
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City | STERLING
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State | MA
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Zip | 01564-1434
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Country | US
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Telephone | 978-422-7314
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Fax |
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Provider Business Mailing Address
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Address Line | 32 WORCESTER RD PO BOX 459
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City | STERLING
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State | MA
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Zip | 01564-1434
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Country | US
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Telephone | 978-422-7314
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | MA13837
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License Number State | MA
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