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General NPI Number Information
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NPI Number | 1285623504
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Entity Type | Organization
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Legal Business Name | CHERRY HILL DENTAL ASSOCIATES INC
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 220 DIEGO DR
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City | COLUMBIA
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State | MO
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Zip | 65203-4919
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Country | US
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Telephone | 573-446-0880
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Fax | 573-447-3121
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Provider Business Mailing Address
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Address Line | 220 DIEGO DR STE 201
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City | COLUMBIA
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State | MO
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Zip | 65203-4923
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Country | US
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Telephone | 573-446-0880
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Fax | 573-447-3121
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. ANTHONY MICHAEL GADBOIS
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Credential | D.D.S
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Telephone | 573-446-0880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 2000158124
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License Number State | MO
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Taxonomy #2
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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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