Individual
ANGELINA SALEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
175 W VAN RIPER RD, FOWLERVILLE, MI 48836
(517) 223-3779
Mailing address
13862 FOREST RIDGE CIR, SOUTH LYON, MI 48178-9821
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901600213
MI
Other
Enumeration date
10/23/2019
Last updated
03/21/2022
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