Provider Demographics
NPI:1578776423
Name:SOLTYS, BRIAN F (DDS)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:F
Last Name:SOLTYS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2123 CARRINGTON CHASE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114-8414
Mailing Address - Country:US
Mailing Address - Phone:815-636-9200
Mailing Address - Fax:815-397-6804
Practice Address - Street 1:435 N MULFORD RD
Practice Address - Street 2:SUITE 11
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-5189
Practice Address - Country:US
Practice Address - Phone:815-397-8600
Practice Address - Fax:815-397-6804
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist