Provider Demographics
NPI:1619190303
Name:SHERWOOD, JOHN W (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:SHERWOOD
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 1:185 DELAWARE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:PALMERTON
Mailing Address - State:PA
Mailing Address - Zip Code:18071-1716
Mailing Address - Country:US
Mailing Address - Phone:610-826-3656
Mailing Address - Fax:610-826-7110
Practice Address - Street 1:185 DELAWARE AVE STE B
Practice Address - Street 2:
Practice Address - City:PALMERTON
Practice Address - State:PA
Practice Address - Zip Code:18071-1716
Practice Address - Country:US
Practice Address - Phone:610-826-3656
Practice Address - Fax:610-826-7110
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0257331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice