Provider Demographics
NPI:1326588039
Name:THOMAS, SHERIDA R (DENTAL HYGIENIST)
Entity type:Individual
Prefix:MRS
First Name:SHERIDA
Middle Name:R
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST
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Mailing Address - Street 1:1061 HARMON AVE
Mailing Address - Street 2:US ARMY DENTAL HEALTH ACTIVITY
Mailing Address - City:FORT STEWART
Mailing Address - State:GA
Mailing Address - Zip Code:31314-5641
Mailing Address - Country:US
Mailing Address - Phone:912-435-7006
Mailing Address - Fax:912-435-7042
Practice Address - Street 1:1061 HARMON AVE
Practice Address - Street 2:ATTN: CREDENTIALS OFFICE,US ARMY DENTAL HEALTH ACTIVITY
Practice Address - City:FORT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314-5641
Practice Address - Country:US
Practice Address - Phone:912-435-7006
Practice Address - Fax:912-435-7042
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GADH011640124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist