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General NPI Number Information
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NPI Number | 1578789533
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Entity Type | Individual
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Provider Name | WILLIAM KELLEY CHERRY D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 09/16/2009
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Provider Practice Location Address
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Address Line | 1640 SCOTTSVILLE RD SUITE 300
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City | BOWLING GREEN
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State | KY
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Zip | 42104-3245
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Country | US
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Telephone | 270-796-3738
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Fax |
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Provider Business Mailing Address
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Address Line | 1878 RICHPOND RD
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City | BOWLING GREEN
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State | KY
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Zip | 42104-8724
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Country | US
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Telephone | 270-796-3738
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 7646
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 7646
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License Number State | KY
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