Provider Demographics
NPI:1205162500
Name:WERNER, SHELDON H (DDS)
Entity type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:H
Last Name:WERNER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 MALONEY RD
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-6258
Mailing Address - Country:US
Mailing Address - Phone:845-462-0630
Mailing Address - Fax:845-462-8785
Practice Address - Street 1:308 MALONEY RD
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-6258
Practice Address - Country:US
Practice Address - Phone:845-462-0630
Practice Address - Fax:845-462-8785
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY24713122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist