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General NPI Number Information
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NPI Number | 1871334326
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Entity Type | Individual
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Provider Name | ABDULHAFIDH TALIB SALIM DDS
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Gender | Male
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 921 E MAIN ST # C
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City | PURCELLVILLE
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State | VA
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Zip | 20132-3133
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Country | US
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Telephone | 540-441-3861
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Fax |
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Provider Business Mailing Address
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Address Line | 14225 SHARPSHINNED DR
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City | GAINESVILLE
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State | VA
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Zip | 20155-5833
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Country | US
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Telephone | 571-488-8309
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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 | 0401418977
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License Number State | VA
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