Provider Demographics
NPI:1962521518
Name:SALEH, MARYAM (DDS)
Entity type:Individual
Prefix:DR
First Name:MARYAM
Middle Name:
Last Name:SALEH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1433 ROSE GLEN DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4003
Mailing Address - Country:US
Mailing Address - Phone:916-759-1477
Mailing Address - Fax:
Practice Address - Street 1:4350 MARCONI AVE
Practice Address - Street 2:#100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-4379
Practice Address - Country:US
Practice Address - Phone:916-759-1477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA538631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice