Provider Demographics
NPI:1760405104
Name:SOLSBURG, NEIL RICHARD (DDS)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:RICHARD
Last Name:SOLSBURG
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 1:405 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MI
Mailing Address - Zip Code:49247-1003
Mailing Address - Country:US
Mailing Address - Phone:517-448-8774
Mailing Address - Fax:517-448-8774
Practice Address - Street 1:405 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:MI
Practice Address - Zip Code:49247-1003
Practice Address - Country:US
Practice Address - Phone:517-448-8774
Practice Address - Fax:517-448-8774
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI13043122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist