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General NPI Number Information
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NPI Number | 1386383560
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Entity Type | Individual
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Provider Name | EMILIE SOREL DMD
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Gender | Female
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Dates
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Enumeration Date | 06/03/2022
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Last Update Date | 06/03/2022
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Provider Practice Location Address
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Address Line | 319 LYNNWAY
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City | LYNN
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State | MA
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Zip | 01901-1811
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Country | US
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Telephone | 781-599-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 520 HARRISON AVE APT 502
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City | BOSTON
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State | MA
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Zip | 02118-2744
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Country | US
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Telephone | 518-772-7525
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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 | DN1859381
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License Number State | MA
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