Healthcare Provider Details

I. General information

NPI: 1356037063
Provider Name (Legal Business Name): WILLIAM BRADY SOROKOLIT DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 NORTHEASTERN BLVD STE 201
NASHUA NH
03062-3154
US

IV. Provider business mailing address

14 BUCKHIDE RD
WINDHAM NH
03087-1853
US

V. Phone/Fax

Practice location:
  • Phone: 603-521-8411
  • Fax:
Mailing address:
  • Phone: 817-691-4340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number04836
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: