Provider Demographics
NPI:1497015358
Name:GERALD SHERRICK DENTAL PLLC
Entity Type:Organization
Organization Name:GERALD SHERRICK DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:BLAKE
Authorized Official - Last Name:SHERRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-450-3072
Mailing Address - Street 1:PO BOX 601595
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75360-1595
Mailing Address - Country:US
Mailing Address - Phone:281-450-3072
Mailing Address - Fax:
Practice Address - Street 1:4541 MEDICAL CENTER DR STE 800
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1651
Practice Address - Country:US
Practice Address - Phone:281-450-3072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX255741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty