Healthcare Provider Details

I. General information

NPI: 1972659035
Provider Name (Legal Business Name): CHESTER J SOKOLOWSKI D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 02/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 ASPEN LN
ORANGE CT
06477-2161
US

IV. Provider business mailing address

607 ASPEN LN
ORANGE CT
06477-2161
US

V. Phone/Fax

Practice location:
  • Phone: 203-804-8875
  • Fax: 203-306-3019
Mailing address:
  • Phone: 203-804-8875
  • Fax: 203-306-3019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number6903
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code1223D0004X
TaxonomyDental Anesthesiology
License Number6903
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: