Provider Demographics
NPI:1073576443
Name:SHARON E. LISTER, DDS, P.C.
Entity Type:Organization
Organization Name:SHARON E. LISTER, DDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:E
Authorized Official - Last Name:LISTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:520-623-9479
Mailing Address - Street 1:368 E GRANT RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85705-5783
Mailing Address - Country:US
Mailing Address - Phone:520-623-9479
Mailing Address - Fax:520-623-0044
Practice Address - Street 1:368 E GRANT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-5783
Practice Address - Country:US
Practice Address - Phone:520-623-9479
Practice Address - Fax:520-623-0044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ60451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty