Healthcare Provider Details

I. General information

NPI: 1255449559
Provider Name (Legal Business Name): STUART P. SHEER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 OLD PADONIA RD
COCKEYSVILLE MD
21030-4917
US

IV. Provider business mailing address

12315 FALLS RD
COCKEYSVILLE MD
21030-1614
US

V. Phone/Fax

Practice location:
  • Phone: 410-560-1400
  • Fax: 410-560-2063
Mailing address:
  • Phone: 410-252-5340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number07904
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: