Provider Demographics
NPI:1467624346
Name:SHELLY SOCH,D.M.D.,P.L.L.C.
Entity Type:Organization
Organization Name:SHELLY SOCH,D.M.D.,P.L.L.C.
Other - Org Name:URBAN OASIS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:K
Authorized Official - Last Name:SOCH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:919-380-7624
Mailing Address - Street 1:270 CORNERSTONE DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-8400
Mailing Address - Country:US
Mailing Address - Phone:919-380-7624
Mailing Address - Fax:
Practice Address - Street 1:270 CORNERSTONE DR
Practice Address - Street 2:SUITE 106
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-8400
Practice Address - Country:US
Practice Address - Phone:919-380-7624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty