Provider Demographics
NPI:1487050324
Name:ZEESHAN SALAM DDS PLLC
Entity type:Organization
Organization Name:ZEESHAN SALAM DDS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZEESHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:315-493-1581
Mailing Address - Street 1:40 FRANKLIN ST STE III
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NY
Mailing Address - Zip Code:13619-1377
Mailing Address - Country:US
Mailing Address - Phone:315-493-1581
Mailing Address - Fax:
Practice Address - Street 1:40 FRANKLIN ST STE III
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:NY
Practice Address - Zip Code:13619-1377
Practice Address - Country:US
Practice Address - Phone:315-493-1581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0539501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty