Provider Demographics
NPI:1407889587
Name:SHARFAE, MAGNOLIA MAGGIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAGNOLIA
Middle Name:MAGGIE
Last Name:SHARFAE
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 1:7010 HWY 71 W SUITE 225
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-2019
Mailing Address - Country:US
Mailing Address - Phone:512-288-0400
Mailing Address - Fax:512-288-0482
Practice Address - Street 1:7010 W HIGHWAY 71 STE 225
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735-8341
Practice Address - Country:US
Practice Address - Phone:512-288-0400
Practice Address - Fax:512-288-0482
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19831122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist