Healthcare Provider Details

I. General information

NPI: 1437363256
Provider Name (Legal Business Name): CHERYL B GOLDEN D.D.S.,M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 01/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 E MAIN ST
COLUMBUS OH
43209-2616
US

IV. Provider business mailing address

316 N COLUMBIA AVE
COLUMBUS OH
43209-1419
US

V. Phone/Fax

Practice location:
  • Phone: 614-235-4800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number21421
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: