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General NPI Number Information
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NPI Number | 1164770103
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Entity Type | Organization
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Legal Business Name | DR. WILLIAM KELLEY CHERRY
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Dates
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Enumeration Date | 08/23/2012
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Last Update Date | 08/23/2012
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Provider Practice Location Address
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Address Line | 1640 SCOTTSVILLE RD. SUITE 300 SUITE 300
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City | BOWLING GREEN
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State | KY
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Zip | 42104
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Country | US
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Telephone | 270-842-5300
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Fax | 270-842-5313
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Provider Business Mailing Address
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Address Line | 1640 SCOTTSVILLE ROAD, SUITE 300 SUITE 300
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City | BOWLING GREEN
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State | KY
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Zip | 42104
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Country | US
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Telephone | 270-842-5300
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Fax | 270-842-5313
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Authorized Official
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Title or Position | DENTIST
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Name | DR. WILLIAM KELLEY CHERRY
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Credential | DMD
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Telephone | 270-842-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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