Provider Demographics
NPI:1104965250
Name:SOFER, SYLVAIN (DDS)
Entity type:Individual
Prefix:DR
First Name:SYLVAIN
Middle Name:
Last Name:SOFER
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 1:1101 AVE J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-3511
Mailing Address - Country:US
Mailing Address - Phone:718-338-0040
Mailing Address - Fax:
Practice Address - Street 1:1101 AVE J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-3511
Practice Address - Country:US
Practice Address - Phone:718-338-0040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0313571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice