Provider Demographics
NPI:1265753818
Name:CANTWELL, SOLOMON ISSAC (DMD)
Entity type:Individual
Prefix:DR
First Name:SOLOMON
Middle Name:ISSAC
Last Name:CANTWELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7332 HALSEY CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-6084
Mailing Address - Country:US
Mailing Address - Phone:406-581-4439
Mailing Address - Fax:
Practice Address - Street 1:7332 HALSEY CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-6084
Practice Address - Country:US
Practice Address - Phone:406-581-4439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60154097122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist