Individual
PHILLIP JOHN SHERIDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1045 E STEWART AVE BLDG 2018, PETERSON AFB, CO 80914-2900
(719) 556-1333
Mailing address
559 VINCENT ST. SPACE BASE DELTA 1, PETERSON SPACE FORCE BASE, CO 80914
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D14402
MN
Other
Enumeration date
05/01/2020
Last updated
12/29/2025
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