Provider Demographics
NPI:1174030373
Name:SHARON, EDWARD H (DDS)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:H
Last Name:SHARON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2355 STANFORD COURT
Mailing Address - Street 2:UNIT 701
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112
Mailing Address - Country:US
Mailing Address - Phone:239-566-7425
Mailing Address - Fax:239-593-3430
Practice Address - Street 1:2355 STANFORD COURT
Practice Address - Street 2:UNIT 701
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112
Practice Address - Country:US
Practice Address - Phone:239-566-7425
Practice Address - Fax:239-593-3430
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN230161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice