Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 6903 | CT |
Y | 1223D0004X | Dentist Anesthesiologist | 6903 | CT |
NPI | 1972659035 |
---|---|
Provider Name | Dr. Chester J Sokolowski |
First Address | Orange, CT 06477-2161 |
Second Address | Orange, CT 06477-2161 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 15/02/2016 |