Provider Demographics
NPI:1558537498
Name:POYOUROW, SOLOMON (DDS, MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:SOLOMON
Middle Name:
Last Name:POYOUROW
Suffix:
Gender:M
Credentials:DDS, MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 AVOCADO AVE STE 406
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7705
Mailing Address - Country:US
Mailing Address - Phone:949-760-1601
Mailing Address - Fax:
Practice Address - Street 1:1441 AVOCADO AVE STE 406
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7705
Practice Address - Country:US
Practice Address - Phone:949-760-1601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA561291223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery