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NPI Code Detail

MEDICARE: DR. EDWARD EARL SHERRILL D.D.S.

MEDICARE: DR. EDWARD EARL SHERRILL D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry2949AR

General Provider Information

NPI Number : 1699845834
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD EARL SHERRILL D.D.S.
Provider Business Mailing Address
First Line : 5326 W MARKHAM ST
Second Line : SUITE #3
City : LITTLE ROCK
State : AR
Zip : 72205-3528
Country : US
Telephone Number : 501-666-6477
Fax Number : 501-666-5218
Provider Business Practice Location Address
First Line : 5326 W MARKHAM ST
Second Line : SUITE #3
City : LITTLE ROCK
State : AR
Zip : 72205-3528
Country : US
Telephone Number : 501-666-6477
Fax Number : 501-666-5218
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 07/08/2007

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