Provider Demographics
NPI:1841203387
Name:NERAL, SHEELA KOTRESH (DDS)
Entity Type:Individual
Prefix:
First Name:SHEELA
Middle Name:KOTRESH
Last Name:NERAL
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 1:38215 W 10 MILE RD
Mailing Address - Street 2:SUITE# 5
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-2866
Mailing Address - Country:US
Mailing Address - Phone:248-888-0364
Mailing Address - Fax:248-888-1039
Practice Address - Street 1:38215 W 10 MILE RD
Practice Address - Street 2:SUITE# 5
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-2866
Practice Address - Country:US
Practice Address - Phone:248-888-0364
Practice Address - Fax:248-888-1039
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010159521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice