Individual
DR. JUSTIN PETER SALEM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
107 ELM ST, BENNINGTON, VT 05201-2249
(802) 447-7147
Mailing address
107 ELM ST, BENNINGTON, VT 05201-2249
(802) 447-7147
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1238
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005225
—
VT
Enumeration date
01/11/2006
Last updated
07/08/2007
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