Provider Demographics
NPI:1104915990
Name:SOLSENG, DAVID CARL (OD)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:CARL
Last Name:SOLSENG
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:2200 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6346
Mailing Address - Country:US
Mailing Address - Phone:701-775-3135
Mailing Address - Fax:
Practice Address - Street 1:402 E 3RD ST
Practice Address - Street 2:SUITE #1
Practice Address - City:ADA
Practice Address - State:MN
Practice Address - Zip Code:56510
Practice Address - Country:US
Practice Address - Phone:218-784-4091
Practice Address - Fax:218-784-4092
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2022-06-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ND570152W00000X
MN2705152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2200530OtherMEDICA
ND234001OtherBLUE SHEILD OF ND
MN314004100Medicaid
MN09G48VAOtherBC BS MN
2200530OtherMEDICA CHOICE SELECT
MN09G48VAOtherMA-BLUE PLUS OF MN
800570OtherVISION SERVICES INC
2200530OtherMEDICA-MA
2200530OtherMEDICA PRIMARY
ND60081OtherND MA
126057OtherU CARE MINNESOTA
639111042770OtherPREFERRED ONE
MN314004100OtherDEPT OF HUMAN SERVICES
MN09G48VAOtherBLUE PLUS OF MN
639111042770OtherPREFERRED ONE