Provider Demographics
NPI:1063506012
Name:LINDSTROM, CHERI DENISE (RDH)
Entity Type:Individual
Prefix:MRS
First Name:CHERI
Middle Name:DENISE
Last Name:LINDSTROM
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 ALEXWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348
Mailing Address - Country:US
Mailing Address - Phone:910-497-3200
Mailing Address - Fax:
Practice Address - Street 1:103 SUPERIOR DRIVE
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NC
Practice Address - Zip Code:28390
Practice Address - Country:US
Practice Address - Phone:910-497-3200
Practice Address - Fax:910-497-2209
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7882124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist