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General NPI Number Information
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NPI Number | 1427174705
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Entity Type | Individual
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Provider Name | OLGA SOBOL D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 67 STATE ROUTE 36
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City | WEST LONG BRANCH
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State | NJ
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Zip | 07764-1432
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Country | US
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Telephone | 732-276-4869
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Fax |
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Provider Business Mailing Address
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Address Line | 49 MORRIS DR
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City | OLD BRIDGE
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State | NJ
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Zip | 08857-3546
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Country | US
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Telephone | 718-986-0987
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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 | 052175
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02300500
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License Number State | NJ
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