Individual
DR. JACQUELINE A SOBOTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD, PHD
Contact information
Practice address
875 MAMARONECK AVE, SUITE 302, MAMARONECK, NY 10543-1900
(914) 835-6004
Mailing address
875 MAMARONECK AVE, SUITE 302, MAMARONECK, NY 10543-1900
(914) 835-6004
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
055300-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03632684
—
NY
Enumeration date
07/28/2009
Last updated
02/13/2014
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