MEDICARE: DR. MICHAEL J SOLOMON D.D.S.,M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	20972	TX

General Provider Information

NPI Number	:	1548482706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL J SOLOMON D.D.S.,M.S.

Provider Business Mailing Address
First Line	:	3006 S W S YOUNG DR
Second Line	:
City	:	KILLEEN
State	:	TX
Zip	:	76542-2023
Country	:	US
Telephone Number	:	254-449-7751
Fax Number	:	254-774-8770

Provider Business Practice Location Address
First Line	:	3006 S W S YOUNG DR
Second Line	:
City	:	KILLEEN
State	:	TX
Zip	:	76542-2023
Country	:	US
Telephone Number	:	254-449-7751
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	09/29/2022

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