MEDICARE: CHERYL A. SIEGEL, D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	5679	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710158480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHERYL A. SIEGEL, D.D.S.

Provider Business Mailing Address
First Line	:	4505 FAIR MEADOWS LN STE 209
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-6449
Country	:	US
Telephone Number	:	919-881-9258
Fax Number	:	919-881-9637

Provider Business Practice Location Address
First Line	:	4505 FAIR MEADOWS LN STE 209
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-6449
Country	:	US
Telephone Number	:	919-881-9258
Fax Number	:	919-881-9637

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHERYL A. SIEGEL
Credential	:	D.D.S.
Telephone Number	:	919-881-9258

Provider Enumeration Date	:	03/20/2008
Last Update Date	:	03/20/2008

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