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General NPI Number Information
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NPI Number | 1144462458
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Entity Type | Organization
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Legal Business Name | SHERI AND RAYMOND CROS DENTAL CORPORATION
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 03/16/2012
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Provider Practice Location Address
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Address Line | 71843 HIGHWAY 111 SUITE A
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-4418
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Country | US
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Telephone | 760-444-3202
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Fax |
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Provider Business Mailing Address
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Address Line | 71843 HIGHWAY 111 SUITE A
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City | RANCHO MIRAGE
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State | CA
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Zip | 92270-4418
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Country | US
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Telephone | 760-444-3202
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. SHERI FAGO CROS
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Credential | DMD
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Telephone | 760-444-3202
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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 | 58148
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 56314
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License Number State | CA
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