Healthcare Provider Details

I. General information

NPI: 1356236285
Provider Name (Legal Business Name): SALVADOR V SOLORIO ENRIQUEZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 SUNCREST TOWN CENTRE DR
MORGANTOWN WV
26505-1814
US

IV. Provider business mailing address

749 RICHWOOD AVE APT 1
MORGANTOWN WV
26505-5787
US

V. Phone/Fax

Practice location:
  • Phone: 831-225-9516
  • Fax:
Mailing address:
  • Phone: 831-225-9516
  • Fax: 831-225-9516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberIP2403
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: