Provider Demographics
NPI:1295317097
Name:SHARP, MICHAEL MEEK (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MEEK
Last Name:SHARP
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2194 SNAKE RIVER PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83402-4351
Mailing Address - Country:US
Mailing Address - Phone:208-757-6245
Mailing Address - Fax:208-757-6264
Practice Address - Street 1:2194 SNAKE RIVER PKWY STE 101
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83402-4351
Practice Address - Country:US
Practice Address - Phone:208-757-6245
Practice Address - Fax:208-757-6264
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-5512122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist