Provider Demographics
NPI:1992856843
Name:STILLE, SHEILA O'GRADY (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:O'GRADY
Last Name:STILLE
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 1:5307 S HAVANA CT
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3815
Mailing Address - Country:US
Mailing Address - Phone:720-287-1845
Mailing Address - Fax:
Practice Address - Street 1:13065 17TH AVE.
Practice Address - Street 2:UNIVERSITY OF COLORADO SCHOOL OF DENTAL MEDICINE
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045
Practice Address - Country:US
Practice Address - Phone:303-724-6624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA199321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice