Provider Demographics
NPI:1326136896
Name:WATERS, SHERRY LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHERRY
Middle Name:LYNN
Last Name:WATERS
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 1:2733 E OVERLOOK RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44106-2803
Mailing Address - Country:US
Mailing Address - Phone:440-899-7950
Mailing Address - Fax:
Practice Address - Street 1:660 DOVER CENTER RD
Practice Address - Street 2:
Practice Address - City:BAY VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44140-2370
Practice Address - Country:US
Practice Address - Phone:440-899-7950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH209141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice