Individual
KENNETH DONALD SALO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11816 MISSISSIPPI DR N, CHAMPLIN, MN 55316-2513
(763) 421-2732
Mailing address
11816 MISSISSIPPI DR N, CHAMPLIN, MN 55316-2513
(763) 421-2732
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6800
MN
Other
Enumeration date
12/30/2008
Last updated
12/30/2008
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