Provider Demographics
NPI:1083745293
Name:SOLON DENTAL CENTER
Entity Type:Organization
Organization Name:SOLON DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARI
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAGANMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:319-624-4444
Mailing Address - Street 1:401 E HAGANMAN LN
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:IA
Mailing Address - Zip Code:52333-9760
Mailing Address - Country:US
Mailing Address - Phone:319-624-4444
Mailing Address - Fax:319-624-6178
Practice Address - Street 1:401 E HAGANMAN LN
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:IA
Practice Address - Zip Code:52333-9760
Practice Address - Country:US
Practice Address - Phone:319-624-4444
Practice Address - Fax:319-624-6178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA77131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty