Provider Demographics
NPI:1144257445
Name:SOLOF, GREGORY J (DDS)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:J
Last Name:SOLOF
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 1:20 W AVON RD
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-3677
Mailing Address - Country:US
Mailing Address - Phone:860-675-3789
Mailing Address - Fax:860-673-6784
Practice Address - Street 1:20 W AVON RD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3677
Practice Address - Country:US
Practice Address - Phone:860-675-3789
Practice Address - Fax:860-673-6784
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT90091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice