Provider Demographics
NPI:1366987638
Name:ALL ABOUT SMILES ROSEVILLE P.C
Entity type:Organization
Organization Name:ALL ABOUT SMILES ROSEVILLE P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:H
Authorized Official - Last Name:SALAH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-981-1199
Mailing Address - Street 1:25631 GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-4434
Mailing Address - Country:US
Mailing Address - Phone:586-775-3312
Mailing Address - Fax:
Practice Address - Street 1:25631 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-4434
Practice Address - Country:US
Practice Address - Phone:586-775-3312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-22
Last Update Date:2020-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010185081223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Single Specialty