Provider Demographics
NPI:1922462134
Name:JENNIFER A SOKOLOSKY DMD, PA
Entity Type:Organization
Organization Name:JENNIFER A SOKOLOSKY DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SOKOLOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:410-531-2690
Mailing Address - Street 1:6100 DAYLONG LN
Mailing Address - Street 2:SUITE 105
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1626
Mailing Address - Country:US
Mailing Address - Phone:410-531-2690
Mailing Address - Fax:
Practice Address - Street 1:6100 DAYLONG LN
Practice Address - Street 2:SUITE 105
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1626
Practice Address - Country:US
Practice Address - Phone:410-531-2690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11614122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty