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General NPI Number Information
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NPI Number | 1518257542
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Entity Type | Individual
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Provider Name | CHRISTOPHER JOHN SHEAREN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 12/16/2019
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Provider Practice Location Address
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Address Line | THE ORAL SURGERY CENTER 8401 SEASONS PARKWAY
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City | WOODBURY
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State | MN
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Zip | 55125
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Country | US
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Telephone | 651-233-2140
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Fax | 651-738-9048
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Provider Business Mailing Address
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Address Line | THE ORAL SURGERY CENTER 8401 SEASONS PARKWAY
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City | WOODBURY
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State | MN
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Zip | 55125
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Country | US
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Telephone | 651-233-2140
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Fax | 651-738-9048
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | D13119
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License Number State | MN
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