Provider Demographics
NPI:1871050690
Name:SHERRY DENTAL PC
Entity type:Organization
Organization Name:SHERRY DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:P
Authorized Official - Last Name:SHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:570-386-6910
Mailing Address - Street 1:757 FREDERICKS GROVE ROAD
Mailing Address - Street 2:
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235
Mailing Address - Country:US
Mailing Address - Phone:570-386-6910
Mailing Address - Fax:570-386-4206
Practice Address - Street 1:757 FREDERICKS GROVE ROAD
Practice Address - Street 2:
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235
Practice Address - Country:US
Practice Address - Phone:570-386-6910
Practice Address - Fax:570-386-4206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty