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General NPI Number Information
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NPI Number | 1205873312
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Entity Type | Individual
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Provider Name | JASON J SOL DDS
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Gender | Male
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 9547 ROOSEVELT AVE FL 2 SOL DENTAL PC
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372-8028
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Country | US
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Telephone | 718-898-4745
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Fax | 718-397-1308
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Provider Business Mailing Address
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Address Line | 261 THOMPSON SHORE RD
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City | MANHASSET
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State | NY
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Zip | 11030-2240
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Country | US
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Telephone | 917-748-7726
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Fax | 718-397-1308
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 052260
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License Number State | NY
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