Provider Demographics
NPI:1942326350
Name:SHERMAN DENTAL ASSOCIATES OF EVANSTON, LTD
Entity Type:Organization
Organization Name:SHERMAN DENTAL ASSOCIATES OF EVANSTON, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY OF TREASURE
Authorized Official - Prefix:
Authorized Official - First Name:LIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-475-6300
Mailing Address - Street 1:909 DAVIS ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-3683
Mailing Address - Country:US
Mailing Address - Phone:847-475-6300
Mailing Address - Fax:847-475-6560
Practice Address - Street 1:909 DAVIS ST
Practice Address - Street 2:SUITE 120
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3683
Practice Address - Country:US
Practice Address - Phone:847-475-6300
Practice Address - Fax:847-475-6560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty