Organization
FREDERICK A. PORT, DMD & GREG S. SOLOMON, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG SOLOMON DDS (PRESIDENT)
(207) 945-5952
Entity
Organization
Contact information
Practice address
700 MOUNT HOPE AVE, SUITE 610, BANGOR, ME 04401-5691
(207) 945-5952
Mailing address
700 MOUNT HOPE AVE, SUITE 610, BANGOR, ME 04401-5691
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10909000
—
ME
Enumeration date
08/09/2006
Last updated
08/22/2020
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