Provider Demographics
NPI:1184360620
Name:MICHAEL A. SHERMAN DDS PA
Entity type:Organization
Organization Name:MICHAEL A. SHERMAN DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:904-269-5520
Mailing Address - Street 1:2233 PARK AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-5569
Mailing Address - Country:US
Mailing Address - Phone:904-269-5520
Mailing Address - Fax:904-215-0071
Practice Address - Street 1:2233 PARK AVE STE 401
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-5569
Practice Address - Country:US
Practice Address - Phone:904-269-5520
Practice Address - Fax:904-215-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental