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General NPI Number Information
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NPI Number | 1790061232
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Entity Type | Organization
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Legal Business Name | HORIZON DENTAL GROUP
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Dates
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Enumeration Date | 10/28/2011
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Last Update Date | 10/28/2011
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Provider Practice Location Address
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Address Line | 2770 S HIGHLAND AVE STE 103
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City | LOMBARD
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State | IL
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Zip | 60148-5412
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Country | US
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Telephone | 630-932-5300
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Fax | 630-932-8650
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Provider Business Mailing Address
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Address Line | 2770 S HIGHLAND AVE STE 103
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City | LOMBARD
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State | IL
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Zip | 60148-5412
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Country | US
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Telephone | 630-932-5300
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Fax | 630-932-8650
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Authorized Official
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Title or Position | DENTIST
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Name | DR. MOHAMMED SALAMAH
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Credential | DDS
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Telephone | 630-932-5300
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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 |
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License Number State |
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