Individual
OMAR SALEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
21358
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X09203
BCBS - DENTAL
MA
Enumeration date
03/17/2006
Last updated
10/06/2009
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