Provider Demographics
NPI:1891079521
Name:SOBIERALSKI, JOHN ANTHONY (DDS, MS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ANTHONY
Last Name:SOBIERALSKI
Suffix:
Gender:M
Credentials:DDS, MS
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:9225 SIERRA COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-5919
Mailing Address - Country:US
Mailing Address - Phone:916-367-4680
Mailing Address - Fax:916-780-0404
Practice Address - Street 1:9225 SIERRA COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-5919
Practice Address - Country:US
Practice Address - Phone:916-367-4680
Practice Address - Fax:916-780-0404
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA371641223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics