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General NPI Number Information
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NPI Number | 1326189010
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Entity Type | Organization
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Legal Business Name | ROBERT A. SHARP, D.M.D., P.A.
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5101 GATE PKWY STE 4
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7276
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Country | US
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Telephone | 904-998-7707
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Fax | 904-998-7759
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Provider Business Mailing Address
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Address Line | 5101 GATE PKWY STE 4
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7276
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Country | US
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Telephone | 904-998-7707
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Fax | 904-998-7759
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Authorized Official
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Title or Position | PRES.
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Name | ROBERT A. SHARP
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Credential | D.M.D.
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Telephone | 904-998-7707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN 9910
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License Number State | FL
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