Provider Demographics
NPI:1619145463
Name:DARRELL M. SHEETS, DMD PLC
Entity Type:Organization
Organization Name:DARRELL M. SHEETS, DMD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:M
Authorized Official - Last Name:SHEETS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:989-895-7475
Mailing Address - Street 1:1480 W CENTER RD
Mailing Address - Street 2:
Mailing Address - City:ESSEXVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48732-2143
Mailing Address - Country:US
Mailing Address - Phone:989-895-7475
Mailing Address - Fax:989-895-7485
Practice Address - Street 1:1480 W CENTER RD
Practice Address - Street 2:
Practice Address - City:ESSEXVILLE
Practice Address - State:MI
Practice Address - Zip Code:48732-2143
Practice Address - Country:US
Practice Address - Phone:989-895-7475
Practice Address - Fax:989-895-7485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental