Provider Demographics
NPI:1306623095
Name:SALEH, BADER (DDS)
Entity type:Individual
Prefix:
First Name:BADER
Middle Name:
Last Name:SALEH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7614 TERRACE RIVER DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33637-7919
Mailing Address - Country:US
Mailing Address - Phone:813-480-6591
Mailing Address - Fax:
Practice Address - Street 1:7614 TERRACE RIVER DR
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33637-7919
Practice Address - Country:US
Practice Address - Phone:813-480-6591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN285531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice