Provider Demographics
NPI:1427111863
Name:SHARON D GAYLORD DMD PC
Entity type:Organization
Organization Name:SHARON D GAYLORD DMD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:GAYLORD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:410-326-0800
Mailing Address - Street 1:PO BOX 1625
Mailing Address - Street 2:
Mailing Address - City:SOLOMONS
Mailing Address - State:MD
Mailing Address - Zip Code:20688-1625
Mailing Address - Country:US
Mailing Address - Phone:410-326-0800
Mailing Address - Fax:410-326-0802
Practice Address - Street 1:20 CRESTON LN
Practice Address - Street 2:SUITE A
Practice Address - City:SOLOMONS
Practice Address - State:MD
Practice Address - Zip Code:20688-3015
Practice Address - Country:US
Practice Address - Phone:410-326-0800
Practice Address - Fax:410-326-0802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD133051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty