Provider Demographics
NPI:1073689543
Name:SOPKO, ROBERT P (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:SOPKO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4601 LAKE BOONE TRAIL
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607
Mailing Address - Country:US
Mailing Address - Phone:919-781-2334
Mailing Address - Fax:919-781-2334
Practice Address - Street 1:4601 LAKE BOONE TRAIL
Practice Address - Street 2:SUITE 2A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607
Practice Address - Country:US
Practice Address - Phone:919-781-2334
Practice Address - Fax:919-781-2334
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC65281223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics