MEDICARE: BARRY SOCKEL, D.D.S., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DS016047L	PA

General Provider Information

NPI Number	:	1154649135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BARRY SOCKEL, D.D.S., P.C.

Provider Business Mailing Address
First Line	:	6001 CHESTER AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19142-1410
Country	:	US
Telephone Number	:	215-724-6666
Fax Number	:	215-724-2696

Provider Business Practice Location Address
First Line	:	6001 CHESTER AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19142-1410
Country	:	US
Telephone Number	:	215-724-6666
Fax Number	:	214-724-2696

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BARRY SOCKEL
Credential	:	DDS
Telephone Number	:	215-724-6666

Provider Enumeration Date	:	05/14/2010
Last Update Date	:	05/14/2010

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