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General NPI Number Information
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NPI Number | 1861688913
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Entity Type | Individual
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Provider Name | RAY AMER SALLAN D.D.S
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Gender | Male
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Dates
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Enumeration Date | 09/22/2007
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Last Update Date | 10/05/2012
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Provider Practice Location Address
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Address Line | 2360 EAST STADIUM BLVD SUITE 14
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City | ANN ARBOR
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State | MI
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Zip | 48104
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Country | US
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Telephone | 734-677-0793
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Fax |
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Provider Business Mailing Address
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Address Line | 4 NORTHWICK CT.
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City | ANN ARBOR
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State | MI
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Zip | 48105
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Country | US
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Telephone | 954-732-1136
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.027310
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License Number State | IL
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