Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 30-024313 | OH |
NPI | 1053728733 |
---|---|
Provider Name | Dr. Louai Ghaleb Salaita |
First Address | Powell, OH 43065-9844 |
Second Address | Powell, OH 43065-9844 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2014 |
Last Update Date | 12/03/2015 |