Provider Demographics
NPI:1922280585
Name:ALLEY, SHARON P (DMD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:P
Last Name:ALLEY
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 1:721 W MARKET ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611-2456
Mailing Address - Country:US
Mailing Address - Phone:256-232-3415
Mailing Address - Fax:256-230-2648
Practice Address - Street 1:721 W MARKET ST
Practice Address - Street 2:SUITE A
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2456
Practice Address - Country:US
Practice Address - Phone:256-232-3415
Practice Address - Fax:256-230-2648
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL55801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice