Provider Demographics
NPI:1518997006
Name:SHERIDAN, DANIEL PATRICK (DDS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:PATRICK
Last Name:SHERIDAN
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 1:138 HARROW LANE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-6048
Mailing Address - Country:US
Mailing Address - Phone:989-792-4331
Mailing Address - Fax:989-792-0044
Practice Address - Street 1:138 HARROW LANE
Practice Address - Street 2:SUITE 1
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-6048
Practice Address - Country:US
Practice Address - Phone:989-792-4331
Practice Address - Fax:989-792-0044
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI015358122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist