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General NPI Number Information
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NPI Number | 1356037063
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Entity Type | Individual
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Provider Name | WILLIAM BRADY SOROKOLIT DMD
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Gender | Male
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Dates
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Enumeration Date | 04/14/2023
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 220 MAIN ST
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City | SALEM
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State | NH
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Zip | 03079-3185
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Country | US
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Telephone | 603-898-1450
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Fax | 603-893-8751
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Provider Business Mailing Address
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Address Line | 3 ARTISAN DR UNIT 163
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City | SALEM
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State | NH
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Zip | 03079-3085
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Country | US
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Telephone | 817-691-4340
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 04836
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License Number State | NH
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