Cherry Lane Dental

NPI 1083660021 - Point of Service - 305S00000X

NPI Details
NPI 1083660021
Enumeration Date 05/25/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name JOHN ANDREW JOHN
Position PRESIDENT
Phone (208) 888-7889
Fax
Practice Location
1104 W CHERRY LN
MERIDIAN ID, 83642-1513, US
Phone (208) 888-7889
Fax
Business Location
1104 W CHERRY LN
MERIDIAN ID, 83642-1513, US
Phone (208) 888-7889
Fax
Toxanomy
Taxonomy Code 305S00000X
License State Idaho
License Number D-3409
Remove 1083660021 NPI Number
 

According to our database, Cherry Lane Dental NPI is 1083660021, taxonomy code is 305S00000X and license number is D-3409, license state is located at Idaho. Cherry Lane Dental physically located at 1104 W Cherry Ln, Meridian ID, 83642-1513. NPI Number 1033115704 has the healthcare provider type.

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1083660021 NPI number is provided on an as is basis without warranty of any kind. 1083660021 is maintained by the National Plan & Provider Enumeration System. The contents of Cherry Lane Dental are for informational purposes only.