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General NPI Number Information
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NPI Number | 1801180542
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Entity Type | Individual
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Provider Name | MICHAEL RYAN SOLIS DDS
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Gender | Male
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Dates
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Enumeration Date | 05/29/2011
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Last Update Date | 03/30/2015
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Provider Practice Location Address
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Address Line | 2321 IRA E WOODS AVE SUITE 100
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City | GRAPEVINE
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State | TX
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Zip | 76051-8632
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Country | US
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Telephone | 817-310-5852
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Fax | 817-310-5922
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Provider Business Mailing Address
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Address Line | 2305 WORTHINGTON ST APT 121
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City | DALLAS
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State | TX
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Zip | 75204-2747
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Country | US
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Telephone | 972-740-5845
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 26560
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License Number State | TX
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