Individual
NATHANAEL SALLOUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
494 HIGHLAND AVE, NEWPORT, VT 05855-4919
(802) 334-1400
Mailing address
494 HIGHLAND AVE, NEWPORT, VT 05855-4919
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
016.0134274
VT
Other
Enumeration date
06/13/2024
Last updated
06/13/2024
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