Provider Demographics
NPI:1154857126
Name:SOLLENBERGER, DAVID EMANUEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EMANUEL
Last Name:SOLLENBERGER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2496 ROCKY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2850
Mailing Address - Country:US
Mailing Address - Phone:205-438-7213
Mailing Address - Fax:
Practice Address - Street 1:2496 ROCKY RIDGE RD
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-2850
Practice Address - Country:US
Practice Address - Phone:205-438-7213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AL64521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program