Healthcare Provider Details

I. General information

NPI: 1174693402
Provider Name (Legal Business Name): DOROTHY LYNN DALTON-SHERIDAN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S FREDERICK AVE STE 213
GAITHERSBURG MD
20877-4152
US

IV. Provider business mailing address

316 SUMMIT HALL RD
GAITHERSBURG MD
20877-1824
US

V. Phone/Fax

Practice location:
  • Phone: 301-330-2000
  • Fax: 301-330-2002
Mailing address:
  • Phone: 301-921-9271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberS01279
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: