MEDICARE: DR. STEVEN J. SOLOW D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	DS019948L	PA
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DS019948L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	32953	OTHER	PA	UNITED CONCORDIA

General Provider Information

NPI Number	:	1750442687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN J. SOLOW D.M.D.

Provider Business Mailing Address
First Line	:	400 OAKWYNNE DR
Second Line	:
City	:	WYNNEWOOD
State	:	PA
Zip	:	19096-2352
Country	:	US
Telephone Number	:	610-642-3168
Fax Number	:

Provider Business Practice Location Address
First Line	:	990 CITY AVE
Second Line	:
City	:	WYNNEWOOD
State	:	PA
Zip	:	19096-4005
Country	:	US
Telephone Number	:	610-649-8383
Fax Number	:	610-649-5484

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	02/02/2015

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