Provider Demographics
NPI:1609134634
Name:C E SOLANO DMD, PC
Entity Type:Organization
Organization Name:C E SOLANO DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL AND MAXILLOFACIAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:E
Authorized Official - Last Name:SOLANO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:816-525-8660
Mailing Address - Street 1:708 NW COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-5710
Mailing Address - Country:US
Mailing Address - Phone:816-525-8660
Mailing Address - Fax:816-554-1253
Practice Address - Street 1:708 NW COMMERCE DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-5710
Practice Address - Country:US
Practice Address - Phone:816-525-8660
Practice Address - Fax:816-554-1253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0152701223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO0003589AMedicare PIN
MOU37517Medicare UPIN