Provider Demographics
NPI:1356417828
Name:DR ROBERT J STANCILL DDS MS AND DR ROBERT P SOPKO DDS PA
Entity type:Organization
Organization Name:DR ROBERT J STANCILL DDS MS AND DR ROBERT P SOPKO DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:KELLY
Authorized Official - Last Name:MANSFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-781-2334
Mailing Address - Street 1:4601 LAKE BOONE TRAIL
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607
Mailing Address - Country:US
Mailing Address - Phone:919-781-2334
Mailing Address - Fax:919-781-2334
Practice Address - Street 1:4601 LAKE BOONE TRAIL
Practice Address - Street 2:SUITE 2A
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607
Practice Address - Country:US
Practice Address - Phone:919-781-2334
Practice Address - Fax:919-781-2334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5880 DR STANCILL1223E0200X
NC6528 DR SOPKO1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty