Individual
ANVAR SALAKHUTDINOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1619 GRANT AVE STE 23, PHILADELPHIA, PA 19115-3161
(215) 673-4940
(215) 673-4960
Mailing address
1619 GRANT AVE STE 23, PHILADELPHIA, PA 19115-3161
(215) 673-4940
(215) 673-4960
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS044217
PA
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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