Provider Demographics
NPI:1831930692
Name:SHEEHAN, GABRIELLE M (DMD)
Entity type:Individual
Prefix:DR
First Name:GABRIELLE
Middle Name:M
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 RIGGS AVE
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-2712
Mailing Address - Country:US
Mailing Address - Phone:856-889-5805
Mailing Address - Fax:
Practice Address - Street 1:901 ROUTE NJ-168
Practice Address - Street 2:SUITE 501
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012
Practice Address - Country:US
Practice Address - Phone:856-228-6688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI03031300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist