Provider Demographics
NPI:1205180171
Name:RICHARD L. SHERMAN, D.D.S.
Entity Type:Organization
Organization Name:RICHARD L. SHERMAN, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:954-680-4443
Mailing Address - Street 1:4725 SW 148 AVE SUITE 203
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330
Mailing Address - Country:US
Mailing Address - Phone:954-680-4443
Mailing Address - Fax:954-434-5080
Practice Address - Street 1:4725 SW 148 AVE. SUITE 203
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33330
Practice Address - Country:US
Practice Address - Phone:954-680-4443
Practice Address - Fax:954-434-5080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL61391223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty