Provider Demographics
NPI:1821153107
Name:DUCHIN, SHELDON L (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:L
Last Name:DUCHIN
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 1:1 KNEELAND ST., 12TH FLOOR
Mailing Address - Street 2:TUFTS UNIVERSITY SCHOOL OF DENTAL MEDICINE, DEPT OF PER
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111
Mailing Address - Country:US
Mailing Address - Phone:617-462-4606
Mailing Address - Fax:
Practice Address - Street 1:1 KNEELAND ST., 12TH FLOOR
Practice Address - Street 2:TUFTS UNIVERSITY SCHOOL OF DENTAL MEDICINE, DEPT OF PER
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111
Practice Address - Country:US
Practice Address - Phone:617-462-4606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA126011223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics