Provider Demographics
NPI:1891386744
Name:LARISA SOKOLSON, PLLC
Entity type:Organization
Organization Name:LARISA SOKOLSON, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LARISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOKOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:860-392-9100
Mailing Address - Street 1:15 MORGAN FARMS DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-1391
Mailing Address - Country:US
Mailing Address - Phone:860-644-4741
Mailing Address - Fax:860-644-6805
Practice Address - Street 1:15 MORGAN FARMS DR
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-1391
Practice Address - Country:US
Practice Address - Phone:860-644-4741
Practice Address - Fax:860-644-6805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty