Provider Demographics
NPI:1407830417
Name:SHERMAN, STEFAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEFAN
Middle Name:
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 1:351 W 6TH STREET
Mailing Address - Street 2:
Mailing Address - City:FORT STEWART
Mailing Address - State:GA
Mailing Address - Zip Code:31314
Mailing Address - Country:US
Mailing Address - Phone:912-767-8513
Mailing Address - Fax:
Practice Address - Street 1:3295 FORNEY ST
Practice Address - Street 2:
Practice Address - City:FORT JACKSON
Practice Address - State:SC
Practice Address - Zip Code:29207-5604
Practice Address - Country:US
Practice Address - Phone:803-751-6213
Practice Address - Fax:803-751-6886
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034842122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist