Provider Demographics
NPI:1801100284
Name:SHERMAN, DENNIS LEE (CST/CFA)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:LEE
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:CST/CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 COUNTY ROAD 157
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-9337
Mailing Address - Country:US
Mailing Address - Phone:419-898-0268
Mailing Address - Fax:
Practice Address - Street 1:615 FULTON ST
Practice Address - Street 2:
Practice Address - City:PORT CLINTON
Practice Address - State:OH
Practice Address - Zip Code:43452-2001
Practice Address - Country:US
Practice Address - Phone:419-734-3131
Practice Address - Fax:419-732-4062
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist