Provider Demographics
NPI:1871646836
Name:SHARNICK, MAUREEN O'DONNELL (DMD)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:O'DONNELL
Last Name:SHARNICK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 BRIDGEPORT AVE
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-3844
Mailing Address - Country:US
Mailing Address - Phone:203-925-8510
Mailing Address - Fax:203-925-8518
Practice Address - Street 1:375 BRIDGEPORT AVE
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-3844
Practice Address - Country:US
Practice Address - Phone:203-925-8510
Practice Address - Fax:203-925-8518
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT75051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice