Provider Demographics
NPI:1205015609
Name:ERIC C. SOLBERG D.D.S.
Entity Type:Organization
Organization Name:ERIC C. SOLBERG D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:C
Authorized Official - Last Name:SOLBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-595-8484
Mailing Address - Street 1:PO BOX 3142
Mailing Address - Street 2:
Mailing Address - City:CAREFREE
Mailing Address - State:AZ
Mailing Address - Zip Code:85377-3142
Mailing Address - Country:US
Mailing Address - Phone:480-595-8484
Mailing Address - Fax:480-595-6074
Practice Address - Street 1:7301 E. SUNDANCE TRAIL
Practice Address - Street 2:STE 101D
Practice Address - City:CAREFREE
Practice Address - State:AZ
Practice Address - Zip Code:85377-3142
Practice Address - Country:US
Practice Address - Phone:480-595-8484
Practice Address - Fax:480-595-6074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD4829122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty