Provider Demographics
NPI:1528034014
Name:SHEPPARD, STANLEY AARON (DMD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:AARON
Last Name:SHEPPARD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2424 E PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5301
Mailing Address - Country:US
Mailing Address - Phone:850-878-1177
Mailing Address - Fax:850-877-3854
Practice Address - Street 1:2424 E PLAZA DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5301
Practice Address - Country:US
Practice Address - Phone:850-878-1177
Practice Address - Fax:850-877-3854
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL47021223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry