Provider Demographics
NPI:1013006741
Name:SOCKWELL, MARCELLA C (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARCELLA
Middle Name:C
Last Name:SOCKWELL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1142
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-1142
Mailing Address - Country:US
Mailing Address - Phone:919-693-8922
Mailing Address - Fax:919-693-4444
Practice Address - Street 1:111 E INDUSTRY DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565-3559
Practice Address - Country:US
Practice Address - Phone:919-693-8922
Practice Address - Fax:919-693-4444
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5799122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC91694OtherBCBSNC PROVIDER ID NUMBER
NC5799OtherLICENSE NUMBER