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Individual

DR. GEORGE A. M. SONBOL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
4003 S NOVA RD, PORT ORANGE, FL 32127-4922
(386) 763-2000
(386) 763-2080
Mailing address
706 BRIGHTVIEW DR, LAKE MARY, FL 32746-2336
(504) 919-1987

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
0401411922
VA
1223G0001X
General Practice Dentistry
DE00011239
WA
1223G0001X
General Practice Dentistry
Primary
DN19532
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5057021
WA
Enumeration date
07/25/2007
Last updated
12/15/2011
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