Provider Demographics
NPI:1356410187
Name:SHERRILL, ALAN WAYNE (DMD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:WAYNE
Last Name:SHERRILL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 SCHUBERT DR
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-3382
Mailing Address - Country:US
Mailing Address - Phone:610-269-3978
Mailing Address - Fax:610-269-9670
Practice Address - Street 1:104 SCHUBERT DR
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-3382
Practice Address - Country:US
Practice Address - Phone:610-269-3978
Practice Address - Fax:610-269-9670
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS24711L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice