Provider Demographics
NPI:1679747562
Name:SHEEHAN, F. MICHAEL III (DDS)
Entity Type:Individual
Prefix:DR
First Name:F.
Middle Name:MICHAEL
Last Name:SHEEHAN
Suffix:III
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 1:11901 S 80TH AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-3102
Mailing Address - Country:US
Mailing Address - Phone:708-671-1510
Mailing Address - Fax:708-671-1643
Practice Address - Street 1:11901 S 80TH AVE
Practice Address - Street 2:SUITE D
Practice Address - City:PALOS PARK
Practice Address - State:IL
Practice Address - Zip Code:60464-3102
Practice Address - Country:US
Practice Address - Phone:708-671-1510
Practice Address - Fax:708-671-1643
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190192141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice