Provider Demographics
NPI:1518257542
Name:SHEAREN, CHRISTOPHER JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:SHEAREN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:THE ORAL SURGERY CENTER
Mailing Address - Street 2:8401 SEASONS PARKWAY
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125
Mailing Address - Country:US
Mailing Address - Phone:651-233-2140
Mailing Address - Fax:651-738-9048
Practice Address - Street 1:THE ORAL SURGERY CENTER
Practice Address - Street 2:8401 SEASONS PARKWAY
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125
Practice Address - Country:US
Practice Address - Phone:651-233-2140
Practice Address - Fax:651-738-9048
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND131191223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery