Provider Demographics
NPI:1477833036
Name:SHERMAN, RICHARD M (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
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 1:3047 S SOMER LN
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:MO
Mailing Address - Zip Code:65738-2618
Mailing Address - Country:US
Mailing Address - Phone:402-429-9744
Mailing Address - Fax:
Practice Address - Street 1:3331 E MONTCLAIR ST
Practice Address - Street 2:SUITE A
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-4785
Practice Address - Country:US
Practice Address - Phone:402-429-9744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2012-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20100406061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice