Physician Compare National (NPI:1710192562)

HEALTHCARE PROVIDER: MARC HENRY SALAH DDS

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1710192562
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3678702198
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170208001917
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SALAH
	Individual professional last name
Provider First Name	MARC
	Individual professional first name
Provider Middle Name	H
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF DETROIT MERCY SCHOOL OF DENTISTRY
	Individual professional's medical school
Graduation Year	2001
	Individual professional's medical school graduation year
Primary Specialty	ORAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	DENTIST
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	DENTIST
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	42180 FORD RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 301
	Group Practice or individual's line 2 address
City	CANTON
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	481873677
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M