Provider Demographics
NPI:1851623631
Name:SOLOMON KRAVITZ, LAUREN M (DDS)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:SOLOMON KRAVITZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:MICHELLE
Other - Last Name:KRAVITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:18482 NW 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-3440
Mailing Address - Country:US
Mailing Address - Phone:305-822-9696
Mailing Address - Fax:305-824-9560
Practice Address - Street 1:18482 NW 67TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-3440
Practice Address - Country:US
Practice Address - Phone:305-822-9696
Practice Address - Fax:305-824-9560
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN105541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice