Provider Demographics
NPI:1417040783
Name:DAVID J. SHERRICK D.D.S.,P.C.
Entity Type:Organization
Organization Name:DAVID J. SHERRICK D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SHERRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:518-792-6756
Mailing Address - Street 1:21 BAYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-5822
Mailing Address - Country:US
Mailing Address - Phone:518-792-6756
Mailing Address - Fax:
Practice Address - Street 1:21 BAYWOOD DR
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-5822
Practice Address - Country:US
Practice Address - Phone:518-792-6756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031936261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental