Provider Demographics
NPI:1811868706
Name:SALEM ENDODONTICS, PLLC
Entity type:Organization
Organization Name:SALEM ENDODONTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENDODONTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:203-535-9269
Mailing Address - Street 1:31 MASSACHUSETTS AVE APT 62
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-1413
Mailing Address - Country:US
Mailing Address - Phone:203-535-9269
Mailing Address - Fax:
Practice Address - Street 1:839 WASHINGTON ST STE A
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-2941
Practice Address - Country:US
Practice Address - Phone:203-535-9269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty