Organization
SOLOMON FAMILY DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACY L SOLOMON D.D.S. (PRESIDENT)
(308) 643-2679
Entity
Organization
Contact information
Practice address
544 MCCARTY ST, MERNA, NE 68856-0327
(308) 643-2679
(308) 643-2684
Mailing address
PO BOX 327, MERNA, NE 68856-0327
(308) 643-2679
(308) 643-2684
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6515
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05178
BCBS
NE
05
—
10025242100
—
NE
Enumeration date
11/09/2006
Last updated
08/22/2020
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