Provider Demographics
NPI:1073727186
Name:ALEX, SHERLY JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHERLY
Middle Name:JOHN
Last Name:ALEX
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 W LANCASTER AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-2523
Mailing Address - Country:US
Mailing Address - Phone:610-971-0717
Mailing Address - Fax:
Practice Address - Street 1:744 W LANCASTER AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-2523
Practice Address - Country:US
Practice Address - Phone:610-971-0717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13616122300000X
PADS039718122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist