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General NPI Number Information
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NPI Number | 1740606748
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Entity Type | Individual
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Provider Name | DORIAN SOLOMON
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Gender | Male
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Dates
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Enumeration Date | 03/14/2014
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 2232 GRAND AVE
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City | FORT MYERS
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State | FL
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Zip | 33901-3717
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Country | US
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Telephone | 239-344-2344
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Fax | 239-332-3372
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Provider Business Mailing Address
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Address Line | PO BOX 1357
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City | FORT MYERS
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State | FL
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Zip | 33902-1357
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Country | US
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Telephone | 239-278-3600
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Fax | 239-226-4650
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 0401418773
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 17589
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 30.027033
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN20526
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License Number State | FL
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