Salem Dental Group LLC

NPI #1104361948 in Salem, Massachusetts

Provider Information

NPI Number: 1104361948
Entity Type: Organization
Organization Name: Salem Dental Group LLC
Primary Specialty: Dentist
Enumeration Date: Jan 4, 2017
Last Updated: Jan 4, 2017

Practice Location

Address: 393 ESSEX ST
City: Salem
State: Massachusetts
ZIP Code: 01970-3156
Phone: (978) 744-5912

Authorized Official

Name: RICHARD T MILLER
Title: SOLE MEMBER
Phone: (617) 921-6292

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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