Provider Demographics
NPI:1619023041
Name:SOLOMITA, MYRNA PANTON (DDS)
Entity Type:Individual
Prefix:
First Name:MYRNA
Middle Name:PANTON
Last Name:SOLOMITA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 SERRA WAY
Mailing Address - Street 2:STE 210
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-8519
Mailing Address - Country:US
Mailing Address - Phone:408-946-9900
Mailing Address - Fax:408-946-4950
Practice Address - Street 1:61 SERRA WAY
Practice Address - Street 2:STE 210
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-8519
Practice Address - Country:US
Practice Address - Phone:408-946-9900
Practice Address - Fax:408-946-4950
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA416621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice