# JOHN SALEK-RAHAM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1154760932
- **Gender:** Man
- **Credential:** MD DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 2901021011 | MI | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | S157 | MN | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 4301119400 | MI | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | 67345 | MN | Yes |

## Other

- **Enumeration date:** 06/14/2013
- **Last updated:** 10/20/2020