Provider Demographics
NPI:1861063240
Name:SOLVERE HEALTH CORP.
Entity type:Organization
Organization Name:SOLVERE HEALTH CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:
Authorized Official - Last Name:RANDOLPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-835-6004
Mailing Address - Street 1:76 PROGRESS DR STE 123
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3603
Mailing Address - Country:US
Mailing Address - Phone:914-835-6004
Mailing Address - Fax:914-560-2216
Practice Address - Street 1:76 PROGRESS DR STE 123
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-3603
Practice Address - Country:US
Practice Address - Phone:914-835-6004
Practice Address - Fax:914-560-2216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty