Provider Demographics
NPI:1184065971
Name:SOBOL, HENRY (DMD)
Entity type:Individual
Prefix:MR
First Name:HENRY
Middle Name:
Last Name:SOBOL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16911 SAN FERNAND MISSION BLVD
Mailing Address - Street 2:#192
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-4250
Mailing Address - Country:US
Mailing Address - Phone:833-377-6265
Mailing Address - Fax:
Practice Address - Street 1:23005 SOLEDAD CANYON RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350
Practice Address - Country:US
Practice Address - Phone:833-377-6265
Practice Address - Fax:888-243-2435
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62498122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist