Provider Demographics
NPI:1104309798
Name:SALIH M MAYALIDAG DENTAL CORP
Entity type:Organization
Organization Name:SALIH M MAYALIDAG DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SALIH
Authorized Official - Middle Name:MURAT
Authorized Official - Last Name:MAYALIDAG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-432-9988
Mailing Address - Street 1:6073 N FRESNO ST STE 103
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8614
Mailing Address - Country:US
Mailing Address - Phone:559-432-9988
Mailing Address - Fax:
Practice Address - Street 1:6073 N FRESNO ST STE 103
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8614
Practice Address - Country:US
Practice Address - Phone:559-432-9988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental