Provider Demographics
NPI:1780897892
Name:HOSEA, SHARON KENNEDY (DDS)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:KENNEDY
Last Name:HOSEA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:HOSEA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:635 WEST 14 MILE ROAD
Mailing Address - Street 2:
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017
Mailing Address - Country:US
Mailing Address - Phone:248-288-6070
Mailing Address - Fax:248-288-1315
Practice Address - Street 1:635 WEST 14 MILE ROAD
Practice Address - Street 2:
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017
Practice Address - Country:US
Practice Address - Phone:248-288-6070
Practice Address - Fax:248-288-1315
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI150451223G0001X
MI2901015045122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice