Provider Demographics
NPI:1194830422
Name:GARY SHIERLING DDS PA
Entity Type:Organization
Organization Name:GARY SHIERLING DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIERLING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:239-542-1500
Mailing Address - Street 1:602 TRAVERS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-2516
Mailing Address - Country:US
Mailing Address - Phone:239-481-5930
Mailing Address - Fax:239-542-1502
Practice Address - Street 1:521 CAPE CORAL PKWY W
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-8507
Practice Address - Country:US
Practice Address - Phone:239-542-1500
Practice Address - Fax:239-542-1502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN11878122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty