Provider Demographics
NPI:1669531703
Name:WAIT, SHERYL L (DMD)
Entity type:Individual
Prefix:DR
First Name:SHERYL
Middle Name:L
Last Name:WAIT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:504 INDIAN TRAIL ROAD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047
Mailing Address - Country:US
Mailing Address - Phone:770-921-5100
Mailing Address - Fax:770-381-9038
Practice Address - Street 1:504 INDIAN TRAIL ROAD
Practice Address - Street 2:SUITE 110
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047
Practice Address - Country:US
Practice Address - Phone:770-921-5100
Practice Address - Fax:770-381-9038
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GADN0129511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice