Provider Demographics
NPI:1215946421
Name:TVRDIK, SHARON ELSTON (DDS)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:ELSTON
Last Name:TVRDIK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15501 WILLOWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-5531
Mailing Address - Country:US
Mailing Address - Phone:952-934-7113
Mailing Address - Fax:
Practice Address - Street 1:2418 ENTERPRISE DR
Practice Address - Street 2:STE B
Practice Address - City:MENDOTA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55120-1362
Practice Address - Country:US
Practice Address - Phone:651-452-2116
Practice Address - Fax:651-452-2695
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice