Healthcare Provider Details

I. General information

NPI: 1306034251
Provider Name (Legal Business Name): JEFFREY M SOLOMON D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 NEW RIVERSIDE VILLAGE WAY STE 100
BLUFFTON SC
29910-3447
US

IV. Provider business mailing address

255 NEW RIVERSIDE VILLAGE WAY STE 100
BLUFFTON SC
29910-3447
US

V. Phone/Fax

Practice location:
  • Phone: 843-757-8100
  • Fax:
Mailing address:
  • Phone: 843-757-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number9493
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: