Provider Demographics
NPI:1235525221
Name:WORZALLA, SHARON PATRICIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:PATRICIA
Last Name:WORZALLA
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:PO BOX 11143
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-0343
Mailing Address - Country:US
Mailing Address - Phone:608-770-2703
Mailing Address - Fax:
Practice Address - Street 1:2737 DEVONSHIRE PL NW
Practice Address - Street 2:UNIT A
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-3479
Practice Address - Country:US
Practice Address - Phone:608-770-2703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10014051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice