Healthcare Provider Details

I. General information

NPI: 1902854839
Provider Name (Legal Business Name): THOMAS PATRICK SHEERAN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 PARK AVENUE STE 100
COLLEFEVILLE PA
19426
US

IV. Provider business mailing address

430 PARK AVENUE STE 100
COLLEFEVILLE PA
19426
US

V. Phone/Fax

Practice location:
  • Phone: 610-489-0525
  • Fax: 484-973-6710
Mailing address:
  • Phone: 610-489-0525
  • Fax: 484-973-6710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License NumberDS024305L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: