Provider Demographics
NPI:1902854839
Name:SHEERAN, THOMAS PATRICK (DMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PATRICK
Last Name:SHEERAN
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 1:545 W MAIN ST
Mailing Address - Street 2:SUITE 24
Mailing Address - City:TRAPPE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-1981
Mailing Address - Country:US
Mailing Address - Phone:610-489-0525
Mailing Address - Fax:610-489-4720
Practice Address - Street 1:545 W MAIN ST
Practice Address - Street 2:SUITE 24
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-1981
Practice Address - Country:US
Practice Address - Phone:610-489-0525
Practice Address - Fax:610-489-4720
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024305L1223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU09378Medicare UPIN
PA500298G80Medicare ID - Type Unspecified