Healthcare Provider Details

I. General information

NPI: 1093739518
Provider Name (Legal Business Name): SOLTANI DENTAL LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 MOUNTAIN ST STE 2D
CARSON CITY NV
89703-3811
US

IV. Provider business mailing address

1001 MOUNTAIN ST STE 2D
CARSON CITY NV
89703-3811
US

V. Phone/Fax

Practice location:
  • Phone: 775-882-0313
  • Fax: 775-882-4052
Mailing address:
  • Phone: 775-882-0313
  • Fax: 775-882-4052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number3573
License Number StateNV

VIII. Authorized Official

Name: DR. MOHAMMAD HADI SOLTANI
Title or Position: PRESIDENT/OWNER
Credential: D.D.S.
Phone: 775-882-0313