Provider Demographics
NPI:1699096818
Name:CLEMENTS, SHERYL ANN (DDS)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:ANN
Last Name:CLEMENTS
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 1:301 E STADIUM
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:AR
Mailing Address - Zip Code:71753-2034
Mailing Address - Country:US
Mailing Address - Phone:870-901-7645
Mailing Address - Fax:870-234-2030
Practice Address - Street 1:301 E STADIUM
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753-2034
Practice Address - Country:US
Practice Address - Phone:870-901-7645
Practice Address - Fax:870-234-2030
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3779122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist