Provider Demographics
NPI:1902300585
Name:STEVEN SOKOLIK DMD PC
Entity type:Organization
Organization Name:STEVEN SOKOLIK DMD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SOKOLIK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:319-524-1477
Mailing Address - Street 1:1624 MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:KEOKUK
Mailing Address - State:IA
Mailing Address - Zip Code:52632-3456
Mailing Address - Country:US
Mailing Address - Phone:319-524-1477
Mailing Address - Fax:
Practice Address - Street 1:1624 MORGAN ST
Practice Address - Street 2:
Practice Address - City:KEOKUK
Practice Address - State:IA
Practice Address - Zip Code:52632-3456
Practice Address - Country:US
Practice Address - Phone:319-524-1477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.029656261QD0000X
261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental