Individual
SALOME ZANGALADZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
255 S 17TH ST STE 2306, PHILADELPHIA, PA 19103
(215) 732-8080
Mailing address
255 S 17TH ST STE 2306, PHILADELPHIA, PA 19103-6223
(215) 732-8080
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS042430
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
06/23/2018
Last updated
09/13/2019
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