Provider Demographics
NPI:1649672601
Name:DR. MARCELLA CLIFTON SOCKWELL
Entity type:Organization
Organization Name:DR. MARCELLA CLIFTON SOCKWELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:SOCKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-968-4701
Mailing Address - Street 1:101 CONNER DR
Mailing Address - Street 2:SUITE 403
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7038
Mailing Address - Country:US
Mailing Address - Phone:919-968-4701
Mailing Address - Fax:919-929-6737
Practice Address - Street 1:101 CONNER DR
Practice Address - Street 2:SUITE 403
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7038
Practice Address - Country:US
Practice Address - Phone:919-968-4701
Practice Address - Fax:919-929-6737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-22
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC57991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty