Provider Demographics
NPI:1316141591
Name:PRATT, FREDERICK SHERIDAN (DDS)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:SHERIDAN
Last Name:PRATT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2470 SUNSET POINT RD
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-1515
Mailing Address - Country:US
Mailing Address - Phone:727-799-9090
Mailing Address - Fax:
Practice Address - Street 1:2470 SUNSET POINT RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-1515
Practice Address - Country:US
Practice Address - Phone:727-799-9090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDNOOO8598122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist