Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 035713 | NY |
NPI | 1003820663 |
---|---|
Provider Name | Clifford Salm |
First Address | New York, NY 10022-1082 |
Second Address | New York, NY 10022-1082 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 08/07/2007 |