Provider Demographics
NPI:1023058260
Name:SOLOMON, DAVID BRIAN (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRIAN
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 NORTH MAIN STREET SUITE 201
Mailing Address - Street 2:P.O. BOX 179
Mailing Address - City:CAMBRIDGE
Mailing Address - State:VT
Mailing Address - Zip Code:05444-0179
Mailing Address - Country:US
Mailing Address - Phone:802-644-5135
Mailing Address - Fax:802-644-6516
Practice Address - Street 1:272 N MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:CAMBRIDGE
Practice Address - State:VT
Practice Address - Zip Code:05444-9810
Practice Address - Country:US
Practice Address - Phone:802-644-5135
Practice Address - Fax:802-644-6516
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT016-00010381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice