Provider Demographics
NPI:1689909194
Name:SLY, SHAREL S (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHAREL
Middle Name:S
Last Name:SLY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5927 ALMEDA RD
Mailing Address - Street 2:SUITE J
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7791
Mailing Address - Country:US
Mailing Address - Phone:713-522-1717
Mailing Address - Fax:713-522-1717
Practice Address - Street 1:5927 ALMEDA RD
Practice Address - Street 2:SUITE J
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-7791
Practice Address - Country:US
Practice Address - Phone:713-522-1717
Practice Address - Fax:713-522-1717
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6014122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist