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General NPI Number Information
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NPI Number | 1609044106
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Entity Type | Organization
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Legal Business Name | CHERYL R. LOCKLEAR, DDS
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Dates
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Enumeration Date | 02/19/2008
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 239 S MAIN STREET
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City | RED SPRINGS
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State | NC
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Zip | 28377-0231
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Country | US
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Telephone | 910-843-4262
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Fax | 910-843-1238
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Provider Business Mailing Address
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Address Line | PO BOX 231
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City | RED SPRINGS
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State | NC
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Zip | 28377-0231
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Country | US
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Telephone | 910-843-4262
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Fax | 910-843-1238
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | DR. CHERYL R LOCKLEAR
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Credential | DDS
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Telephone | 910-843-4262
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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 | 4659
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License Number State | NC
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