Provider Demographics
NPI:1235213166
Name:SOLL, DAVID M (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:SOLL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:8 WILTSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3937
Mailing Address - Country:US
Mailing Address - Phone:617-620-4565
Mailing Address - Fax:888-838-8947
Practice Address - Street 1:8 WILTSHIRE RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-3937
Practice Address - Country:US
Practice Address - Phone:617-620-4565
Practice Address - Fax:888-838-8947
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2603152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1991083001OtherCIGNA
MA152724OtherHARVARD
MA719275OtherTUFTS
MAW15191OtherBLUE CROSS OF MA
MA4257304OtherAETNA
MA215058Medicare ID - Type Unspecified
MA152724OtherHARVARD