Provider Demographics
NPI:1649303157
Name:SOLIS, ERICK ROLANDO (DDS)
Entity type:Individual
Prefix:DR
First Name:ERICK
Middle Name:ROLANDO
Last Name:SOLIS
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 1:29491 THE OLD RD
Mailing Address - Street 2:
Mailing Address - City:CASTAIC
Mailing Address - State:CA
Mailing Address - Zip Code:91384-2902
Mailing Address - Country:US
Mailing Address - Phone:661-257-9909
Mailing Address - Fax:661-257-0008
Practice Address - Street 1:29491 THE OLD RD
Practice Address - Street 2:
Practice Address - City:CASTAIC
Practice Address - State:CA
Practice Address - Zip Code:91384-2902
Practice Address - Country:US
Practice Address - Phone:661-257-9909
Practice Address - Fax:661-257-0008
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43660122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist