Basic Information
Provider Information
NPI: 1437394632
EntityType: 2
ReplacementNPI:  
OrganizationName: JANA M. SOKOL DMD, PC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: PO BOX 3189
Address2:  
City: SYRACUSE
State: NY
PostalCode: 132203189
CountryCode: US
TelephoneNumber: 3154546000
FaxNumber:  
Practice Location
Address1: 302-304 MAIN STREET
Address2:  
City: HAVERHILL
State: MA
PostalCode: 01830
CountryCode: US
TelephoneNumber: 9783748788
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/03/2008
LastUpdateDate: 12/03/2008
NPIDeactivationReasonCode:  
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ProviderGenderCode:  
AuthorizedOfficialLastName: SOKOL
AuthorizedOfficialFirstName: JANA
AuthorizedOfficialMiddleName: M
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 9783748788
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: DMD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223G0001X18543MAY193400000X MULTIPLE SINGLE SPECIALTY GROUPDental ProvidersDentistGeneral Practice

No ID Information.


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