Organization
ELLIOT W SALLOWAY DMD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLIOT W SALLOWAY DMD (PRESIDENT TREASURER)
(508) 752-1302
Entity
Organization
Contact information
Practice address
111 ELM ST, STE 203, WORCESTER, MA 01609
(508) 752-1302
(508) 753-5801
Mailing address
111 ELM ST, STE 203, WORCESTER, MA 01609
(508) 752-1302
(508) 753-5801
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
9215
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000608
DELTA DENTAL OF MA
MA
01
—
10444
BCBS MA
MA
Enumeration date
07/17/2006
Last updated
08/22/2020
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