| Organization Name: | SALEM DENTISTRY P.C. |
| NPI Number: | 1154534238 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUSTIN P. SALEM (DENTIST) |
| Mailing Address: | 107 Elm St Bennington |
| State: | VT US |
| Postal Code: | 052012249 |
| Phone Number: | 8024477147 |
| Fax Number: | |
| NPI Enumeration Date: | 05/07/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 016-0001238 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |