Provider Demographics
NPI:1124334537
Name:SALM, ADAM ROSS (DMD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:ROSS
Last Name:SALM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-5012
Mailing Address - Country:US
Mailing Address - Phone:845-342-3900
Mailing Address - Fax:
Practice Address - Street 1:27 NORTH ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-5012
Practice Address - Country:US
Practice Address - Phone:845-342-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055000-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist