Provider Demographics
NPI:1982616769
Name:DOUGLAS A SHEALY DDS PC
Entity Type:Organization
Organization Name:DOUGLAS A SHEALY DDS PC
Other - Org Name:ROWLEY FAMILY DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SHEALY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:978-948-2333
Mailing Address - Street 1:434 HAVERHILL ST
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-1914
Mailing Address - Country:US
Mailing Address - Phone:978-948-2333
Mailing Address - Fax:978-948-3752
Practice Address - Street 1:434 HAVERHILL ST
Practice Address - Street 2:
Practice Address - City:ROWLEY
Practice Address - State:MA
Practice Address - Zip Code:01969-1914
Practice Address - Country:US
Practice Address - Phone:978-948-2333
Practice Address - Fax:978-948-3752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA151821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty