Provider Demographics
NPI:1699155523
Name:SHARP, ALEX
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:SHARP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 S MAIN ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-7800
Mailing Address - Country:US
Mailing Address - Phone:501-268-3223
Mailing Address - Fax:
Practice Address - Street 1:400 S MAIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-7800
Practice Address - Country:US
Practice Address - Phone:501-268-3223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR40471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice