Provider Demographics
NPI:1891224887
Name:SHEAFFER, LISA MARIE BROWN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LISA MARIE
Middle Name:BROWN
Last Name:SHEAFFER
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 1:6837 FALLS OF NEUSE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5308
Mailing Address - Country:US
Mailing Address - Phone:919-846-9070
Mailing Address - Fax:
Practice Address - Street 1:6837 FALLS OF NEUSE RD STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-5308
Practice Address - Country:US
Practice Address - Phone:919-846-9070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC66041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice