Provider Demographics
NPI:1881813848
Name:SHERER, JEFFREY L (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:L
Last Name:SHERER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 N VILLAGE AVE
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3800
Mailing Address - Country:US
Mailing Address - Phone:516-766-0874
Mailing Address - Fax:516-766-0872
Practice Address - Street 1:176 N VILLAGE AVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-3800
Practice Address - Country:US
Practice Address - Phone:516-766-0874
Practice Address - Fax:516-766-0872
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028574122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist