Provider Demographics
NPI:1487911335
Name:THOM, SHARI ANNE (DDS)
Entity type:Individual
Prefix:DR
First Name:SHARI
Middle Name:ANNE
Last Name:THOM
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 1:329 23RD AVE N
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-4608
Mailing Address - Country:US
Mailing Address - Phone:320-237-8005
Mailing Address - Fax:
Practice Address - Street 1:2385 TROOP DR
Practice Address - Street 2:SUITE 201
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-4724
Practice Address - Country:US
Practice Address - Phone:320-251-2972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-17
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13099122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist