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General NPI Number Information
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NPI Number | 1104205822
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Entity Type | Organization
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Legal Business Name | CHERI W CUNNINGHAM DMD
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Dates
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Enumeration Date | 05/27/2015
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Last Update Date | 05/27/2015
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Provider Practice Location Address
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Address Line | 907 MAIN ST
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City | GARDENDALE
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State | AL
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Zip | 35071-2633
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Country | US
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Telephone | 205-285-9661
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Fax | 205-285-9663
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Provider Business Mailing Address
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Address Line | 907 MAIN ST
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City | GARDENDALE
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State | AL
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Zip | 35071-2633
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Country | US
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Telephone | 205-285-9661
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Fax | 205-285-9663
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. CHERI W CUNNINGHAM
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Credential | DMD
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Telephone | 205-285-9661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5328
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License Number State | AL
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