Provider Demographics
NPI:1891875837
Name:FORTSCH-THOMAS, SHERRI (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHERRI
Middle Name:
Last Name:FORTSCH-THOMAS
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 1:3506 WASHINGTON AVE
Mailing Address - Street 2:PO BOX 128
Mailing Address - City:FINLEYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15332-1328
Mailing Address - Country:US
Mailing Address - Phone:724-348-7681
Mailing Address - Fax:724-348-7259
Practice Address - Street 1:3506 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:FINLEYVILLE
Practice Address - State:PA
Practice Address - Zip Code:15332-1328
Practice Address - Country:US
Practice Address - Phone:724-348-7681
Practice Address - Fax:724-348-7259
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-027841-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice