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General NPI Number Information
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NPI Number | 1811540693
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Entity Type | Organization
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Legal Business Name | CHERRY VALLEY SMILES, INC.
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Dates
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Enumeration Date | 07/19/2019
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Last Update Date | 07/19/2019
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Provider Practice Location Address
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Address Line | 101 N MCDONALD ST
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City | MC DONALD
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State | PA
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Zip | 15057-1200
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Country | US
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Telephone | 724-926-1400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 227
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City | HICKORY
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State | PA
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Zip | 15340-0227
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Country | US
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Telephone | 724-986-1974
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SARAH W OGBURN
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Credential | DMD
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Telephone | 724-986-1974
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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 |
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License Number State |
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