Provider Demographics
NPI:1629276878
Name:SOLICH, GREGORY M (DDS)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:M
Last Name:SOLICH
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 1:5426 N ACADEMY BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-3686
Mailing Address - Country:US
Mailing Address - Phone:719-548-9393
Mailing Address - Fax:
Practice Address - Street 1:10807 NEW ALLEGIANCE DR STE 465
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3722
Practice Address - Country:US
Practice Address - Phone:719-548-9393
Practice Address - Fax:719-548-9313
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO051461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice