Provider Demographics
NPI:1649335282
Name:LISANN, SHARI N (DMD)
Entity type:Individual
Prefix:DR
First Name:SHARI
Middle Name:N
Last Name:LISANN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:651 WASHINGTON STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446
Mailing Address - Country:US
Mailing Address - Phone:617-738-4746
Mailing Address - Fax:617-738-3334
Practice Address - Street 1:651 WASHINGTON STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446
Practice Address - Country:US
Practice Address - Phone:617-738-4746
Practice Address - Fax:617-738-3334
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2017-11-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA161761223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics