Healthcare Provider Details

I. General information

NPI: 1487828216
Provider Name (Legal Business Name): LAURA MARIE SOLYNTJES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 01/17/2022
Certification Date: 01/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17705 HUTCHINS DR STE 101
MINNETONKA MN
55345-4102
US

IV. Provider business mailing address

17705 HUTCHINS DRIVE SUITE 101
MINNETONKA MN
55345
US

V. Phone/Fax

Practice location:
  • Phone: 952-401-8300
  • Fax: 952-401-8242
Mailing address:
  • Phone: 952-401-8300
  • Fax: 952-401-8240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number556
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberAC38192365029
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: