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General NPI Number Information
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NPI Number | 1790822823
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Entity Type | Individual
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Provider Name | JOHN R SOBEL D.D.S
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Gender | Male
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 630 5TH AVENUE ROCKEFELLER CENTER SUITES 1853-1854
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City | NEW YORK
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State | NY
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Zip | 10111
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Country | US
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Telephone | 212-541-6220
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Fax | 212-541-6221
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Provider Business Mailing Address
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Address Line | 630 5TH AVENUE SUITES 1853-1854
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City | NEW YORK
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State | NY
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Zip | 10111
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Country | US
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Telephone | 212-541-6220
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Fax | 212-541-6221
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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 | 041543
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License Number State | NY
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