Provider Demographics
NPI:1457393498
Name:SHARP, ROBERT E (DDS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:SHARP
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 1:16 HUNTER BROOK LN
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-5858
Mailing Address - Country:US
Mailing Address - Phone:518-793-5995
Mailing Address - Fax:518-793-5908
Practice Address - Street 1:16 HUNTER BROOK LN
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-5858
Practice Address - Country:US
Practice Address - Phone:518-793-5995
Practice Address - Fax:518-793-5908
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY 328241223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics