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General NPI Number Information
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NPI Number | 1891386744
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Entity Type | Organization
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Legal Business Name | LARISA SOKOLSON, PLLC
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Dates
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Enumeration Date | 02/02/2021
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Last Update Date | 02/02/2021
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Provider Practice Location Address
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Address Line | 15 MORGAN FARMS DR
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-1391
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Country | US
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Telephone | 860-644-4741
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Fax | 860-644-6805
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Provider Business Mailing Address
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Address Line | 15 MORGAN FARMS DR
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-1391
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Country | US
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Telephone | 860-644-4741
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Fax | 860-644-6805
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. LARISA SOKOLSON
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Credential | DMD
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Telephone | 860-392-9100
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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 |
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License Number State |
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