Provider Demographics
NPI:1730313610
Name:FIELD, THEODORE SHELDON III (DMD)
Entity Type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:SHELDON
Last Name:FIELD
Suffix:III
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 1:3020 N MILITARY TRL
Mailing Address - Street 2:SUITE #250
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-1814
Mailing Address - Country:US
Mailing Address - Phone:561-443-4133
Mailing Address - Fax:561-443-3670
Practice Address - Street 1:3020 N MILITARY TRL
Practice Address - Street 2:SUITE #250
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-1814
Practice Address - Country:US
Practice Address - Phone:561-443-4133
Practice Address - Fax:561-443-3670
Is Sole Proprietor?:No
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN161631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice