Healthcare Provider Details

I. General information

NPI: 1952568875
Provider Name (Legal Business Name): MASIH M SOLTANI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 06/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MUNRO AVE
CAPE MAY NJ
08204-5000
US

IV. Provider business mailing address

1 MUNRO AVE US COAST GUARD
CPAE MAY NJ
08204
US

V. Phone/Fax

Practice location:
  • Phone: 609-898-6602
  • Fax:
Mailing address:
  • Phone: 609-898-6602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number4558
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: