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Individual

DR. DOUGLAS L. SHERAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
4120 BARBARA LOOP SE, RIO RANCHO, NM 87124-1000
(505) 892-8086
Mailing address
4120 BARBARA LOOP SE, RIO RANCHO, NM 87124-1000
(505) 892-8086

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1540
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
742807354
FEDERAL FID NUMBER
NM
Enumeration date
10/17/2006
Last updated
07/08/2007
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