Provider Demographics
NPI:1659109593
Name:SALEEB, GIRGIS (DMD)
Entity type:Individual
Prefix:
First Name:GIRGIS
Middle Name:
Last Name:SALEEB
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3135 COLUMBIA BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-7833
Mailing Address - Country:US
Mailing Address - Phone:321-567-2000
Mailing Address - Fax:
Practice Address - Street 1:3135 COLUMBIA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-7833
Practice Address - Country:US
Practice Address - Phone:321-567-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29424122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist