Provider Demographics
NPI:1043730401
Name:SOKOLSON, LARISA (DMD)
Entity Type:Individual
Prefix:DR
First Name:LARISA
Middle Name:
Last Name:SOKOLSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2D GILLETTE CT
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-3121
Mailing Address - Country:US
Mailing Address - Phone:860-392-9100
Mailing Address - Fax:
Practice Address - Street 1:15 MORGAN FARMS DR
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-1391
Practice Address - Country:US
Practice Address - Phone:860-644-4741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-26
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12166122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist