Provider Demographics
NPI:1871728634
Name:SAL DENTAL, P.C.
Entity type:Organization
Organization Name:SAL DENTAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIMITRI
Authorized Official - Middle Name:J
Authorized Official - Last Name:HARALAMPOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-414-3309
Mailing Address - Street 1:2239 W JEFFERSON ST
Mailing Address - Street 2:#104A-105B
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6303
Mailing Address - Country:US
Mailing Address - Phone:815-207-4442
Mailing Address - Fax:
Practice Address - Street 1:2239 W JEFFERSON ST
Practice Address - Street 2:SUITE #104-105/A-B
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6303
Practice Address - Country:US
Practice Address - Phone:815-207-4442
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty