Provider Demographics
NPI:1639453194
Name:SOLOMON, BARRY (DDS)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:
Last Name:SOLOMON
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 1:6301 NW LOOP 410
Mailing Address - Street 2:SUITE L-1A
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-3824
Mailing Address - Country:US
Mailing Address - Phone:210-354-4867
Mailing Address - Fax:
Practice Address - Street 1:6301 NW LOOP 410
Practice Address - Street 2:SUITE L-1A
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-3824
Practice Address - Country:US
Practice Address - Phone:210-354-4867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8481122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist