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General NPI Number Information
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NPI Number | 1134529910
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Entity Type | Organization
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Legal Business Name | ROBERT P. SOPKO, DDS, PA
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Dates
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Enumeration Date | 08/28/2014
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 3708 FORESTVIEW RD STE 201
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City | RALEIGH
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State | NC
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Zip | 27612-8042
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Country | US
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Telephone | 919-819-9289
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Fax | 919-747-4334
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Provider Business Mailing Address
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Address Line | 3708 FORESTVIEW RD STE 201
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City | RALEIGH
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State | NC
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Zip | 27612-8042
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Country | US
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Telephone | 919-819-9289
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Fax | 919-747-4334
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT P SOPKO
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Credential |
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Telephone | 919-819-9289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 6548
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License Number State | NC
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