Provider Demographics
NPI:1366224487
Name:SOLAY DENTAL PA
Entity type:Organization
Organization Name:SOLAY DENTAL PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CCO
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIVA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLEIMANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-366-6037
Mailing Address - Street 1:3144 TAMPA RD STE 3
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-2290
Mailing Address - Country:US
Mailing Address - Phone:727-781-6224
Mailing Address - Fax:
Practice Address - Street 1:3144 TAMPA RD STE 3
Practice Address - Street 2:
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-2290
Practice Address - Country:US
Practice Address - Phone:727-781-6224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty