Provider Demographics
NPI:1437364288
Name:SOLEIMAN PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:SOLEIMAN PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-389-7288
Mailing Address - Street 1:PO BOX 800152
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91380-0152
Mailing Address - Country:US
Mailing Address - Phone:818-389-7288
Mailing Address - Fax:818-386-1001
Practice Address - Street 1:24218 VALENCIA BLVD
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5391
Practice Address - Country:US
Practice Address - Phone:661-288-0288
Practice Address - Fax:661-286-9925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA438601223P0300X
NVS4-61C1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty