Provider Demographics
NPI:1740563949
Name:CARY DENTAL SHERWOOD
Entity Type:Organization
Organization Name:CARY DENTAL SHERWOOD
Other - Org Name:MICHAEL D CARY DMD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:CARY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-925-9992
Mailing Address - Street 1:20015 SW PACIFIC HWY
Mailing Address - Street 2:#220
Mailing Address - City:SHERWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97140-9316
Mailing Address - Country:US
Mailing Address - Phone:503-925-9992
Mailing Address - Fax:503-625-2982
Practice Address - Street 1:20015 SW PACIFIC HWY
Practice Address - Street 2:#220
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-9316
Practice Address - Country:US
Practice Address - Phone:503-925-9992
Practice Address - Fax:503-625-2982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-23
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD6882261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental