| NPI | 1316556053 |
|---|---|
| Former Name | JERDIE MANUEL ALE-SALVO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OH 30.026978) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 1002383-15) |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2024-09-22 |