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NPI Code Detail

MEDICARE: WILLIAM FREDRICK CHERRY II D.D.S.

MEDICARE: WILLIAM FREDRICK CHERRY II 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
11223G0001XGeneral Practice Dentistry10577TX

General Provider Information

NPI Number : 1750305827
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM FREDRICK CHERRY II D.D.S.
Provider Business Mailing Address
First Line : 2426 SOUTH CARRIER PARKWAY
Second Line : SUITE 102
City : GRAND PRAIRIE
State : TX
Zip : 75051-8506
Country : US
Telephone Number : 972-641-8415
Fax Number :
Provider Business Practice Location Address
First Line : 2426 SOUTH CARRIER PARKWAY
Second Line : SUITE 102
City : GRAND PRAIRIE
State : TX
Zip : 75051-8506
Country : US
Telephone Number : 972-641-8415
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2006
Last Update Date : 07/08/2007

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