Provider Demographics
NPI:1740957257
Name:SHAER DENTAL CORPORATION
Entity type:Organization
Organization Name:SHAER DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:VERDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-678-9975
Mailing Address - Street 1:8619 RESEDA BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-4042
Mailing Address - Country:US
Mailing Address - Phone:818-678-9975
Mailing Address - Fax:818-812-9383
Practice Address - Street 1:8619 RESEDA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4042
Practice Address - Country:US
Practice Address - Phone:818-678-9975
Practice Address - Fax:818-812-9383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty