Provider Demographics
NPI:1235104944
Name:SHERMAN, MICHAEL A (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:SHERMAN
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 1:2233 PARK AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-5570
Mailing Address - Country:US
Mailing Address - Phone:904-269-5520
Mailing Address - Fax:904-215-0071
Practice Address - Street 1:2233 PARK AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-5570
Practice Address - Country:US
Practice Address - Phone:904-269-5520
Practice Address - Fax:904-215-0071
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN143781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice