Provider Demographics
NPI:1962498261
Name:GAYLORD, SHARON DENISE (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:DENISE
Last Name:GAYLORD
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 1:23673 JM GOUGH CT
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-3786
Mailing Address - Country:US
Mailing Address - Phone:301-475-3402
Mailing Address - Fax:410-326-0802
Practice Address - Street 1:20 CRESTON LN
Practice Address - Street 2:
Practice Address - City:SOLOMONS
Practice Address - State:MD
Practice Address - Zip Code:20688-3015
Practice Address - Country:US
Practice Address - Phone:410-326-0800
Practice Address - Fax:410-326-0802
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD133051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice