CHERRY LANE DENTAL NPI 1083660021

NPI Information

CHERRY LANE DENTAL is a point of service in Meridian, ID. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. CHERRY LANE DENTAL NPI is 1083660021. The provider is registered as an organization entity type.

The provider's business location address is:

1104 W CHERRY LN
MERIDIAN, ID
ZIP 83642-513
Phone: (208) 888-7889

The provider's authorized official is John Andrew Bergloff .
The authorized official title is President and has the following contact phone number (208) 888-7889.

The enumeration date for this NPI number is 5/25/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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