Provider Demographics
NPI:1649522830
Name:MOHAMED SOLIMAN DENTAL CORP
Entity type:Organization
Organization Name:MOHAMED SOLIMAN DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:ABDELKAWY
Authorized Official - Last Name:SOLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-479-2447
Mailing Address - Street 1:9015 BRUCEVILLE RD STE 130
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-5958
Mailing Address - Country:US
Mailing Address - Phone:916-479-2447
Mailing Address - Fax:
Practice Address - Street 1:5309 IRIS SPRING WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-3302
Practice Address - Country:US
Practice Address - Phone:916-479-2447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52002122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty