Healthcare Provider Details

I. General information

NPI: 1528313236
Provider Name (Legal Business Name): JAMES LEON SOLTYS D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2012
Last Update Date: 07/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W MAIN ST
VICTOR NY
14564-1140
US

IV. Provider business mailing address

105 W MAIN ST
VICTOR NY
14564-1140
US

V. Phone/Fax

Practice location:
  • Phone: 585-924-4180
  • Fax: 585-924-9989
Mailing address:
  • Phone: 585-924-4180
  • Fax: 585-924-9989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number036061
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: