Provider Demographics
NPI:1164879581
Name:SOLETIC, LUKE C (DDS, MD)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:C
Last Name:SOLETIC
Suffix:
Gender:M
Credentials:DDS, MD
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Mailing Address - Street 1:134 MINEOLA BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-3959
Mailing Address - Country:US
Mailing Address - Phone:516-294-9696
Mailing Address - Fax:519-294-3531
Practice Address - Street 1:134 MINEOLA BLVD FL 3
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3959
Practice Address - Country:US
Practice Address - Phone:516-294-9696
Practice Address - Fax:516-294-3531
Is Sole Proprietor?:No
Enumeration Date:2016-05-16
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0625441223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery