Provider Demographics
NPI:1144483967
Name:PRINDLE, SHARON MICHELLE (DDS)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:MICHELLE
Last Name:PRINDLE
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 1:6601 BLUE OAKS BLVD
Mailing Address - Street 2:#301
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5948
Mailing Address - Country:US
Mailing Address - Phone:916-307-2323
Mailing Address - Fax:
Practice Address - Street 1:6601 BLUE OAKS BLVD
Practice Address - Street 2:#301
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5948
Practice Address - Country:US
Practice Address - Phone:916-307-2323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57178122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist