Provider Demographics
NPI:1891790929
Name:SOCKOLOSKY, JAMES MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:SOCKOLOSKY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45139 BROOKSIDE CT
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-3846
Mailing Address - Country:US
Mailing Address - Phone:734-459-4085
Mailing Address - Fax:
Practice Address - Street 1:35000 FORD RD
Practice Address - Street 2:STE 6
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-3719
Practice Address - Country:US
Practice Address - Phone:734-326-2030
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI97931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice