Provider Demographics
NPI:1316300155
Name:ROBERTS, SOLEIL DE MARSCHE (DMD, MSD)
Entity type:Individual
Prefix:DR
First Name:SOLEIL
Middle Name:DE MARSCHE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2714 FAIRVIEW AVE E
Mailing Address - Street 2:APT 301
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3115
Mailing Address - Country:US
Mailing Address - Phone:267-391-8124
Mailing Address - Fax:
Practice Address - Street 1:2714 FAIRVIEW AVE E
Practice Address - Street 2:APT 301
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3115
Practice Address - Country:US
Practice Address - Phone:267-391-8124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE604716501223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics