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General NPI Number Information
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NPI Number | 1952435646
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Entity Type | Organization
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Legal Business Name | OMAR SALEM DMD MS PC
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 07/11/2008
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Provider Practice Location Address
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Address Line | 120 WEST CENTER ST
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City | WEST BRIDGEWATER
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State | MA
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Zip | 02379
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Country | US
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Telephone | 508-588-6500
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Fax | 508-588-6030
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Provider Business Mailing Address
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Address Line | 120 WEST CENTER ST
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City | WEST BRIDGEWATER
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State | MA
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Zip | 02379
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Country | US
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Telephone | 508-588-6500
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Fax | 508-588-6030
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | OMAR SALEM
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Credential | DMD, MSD
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Telephone | 508-588-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 21358
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License Number State | MA
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