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General NPI Number Information
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NPI Number | 1710158480
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Entity Type | Organization
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Legal Business Name | CHERYL A. SIEGEL, D.D.S.
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Dates
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Enumeration Date | 03/20/2008
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 4505 FAIR MEADOWS LN STE 209
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City | RALEIGH
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State | NC
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Zip | 27607-6449
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Country | US
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Telephone | 919-881-9258
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Fax | 919-881-9637
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Provider Business Mailing Address
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Address Line | 4505 FAIR MEADOWS LN STE 209
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City | RALEIGH
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State | NC
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Zip | 27607-6449
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Country | US
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Telephone | 919-881-9258
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Fax | 919-881-9637
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHERYL A. SIEGEL
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Credential | D.D.S.
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Telephone | 919-881-9258
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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 | 5679
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License Number State | NC
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