Provider Demographics
NPI:1205898343
Name:LINDQUIST, SHERRILL FREDERICK (DDS)
Entity type:Individual
Prefix:DR
First Name:SHERRILL
Middle Name:FREDERICK
Last Name:LINDQUIST
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 1:8319 WARLIN DRIVE SOUTH
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:33216
Mailing Address - Country:US
Mailing Address - Phone:813-335-0442
Mailing Address - Fax:
Practice Address - Street 1:1833 BOULEVARD STREET
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32206
Practice Address - Country:US
Practice Address - Phone:904-232-2751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-01-5592122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist