Provider Demographics
NPI:1083710560
Name:MITCHELL-MCCARTHY, CHERYL ANN (DDS)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:MITCHELL-MCCARTHY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3115 W PINEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROSCOMMON
Mailing Address - State:MI
Mailing Address - Zip Code:48653-9320
Mailing Address - Country:US
Mailing Address - Phone:989-745-8027
Mailing Address - Fax:989-821-5566
Practice Address - Street 1:315 W HIGGINS LAKE DR
Practice Address - Street 2:
Practice Address - City:ROSCOMMON
Practice Address - State:MI
Practice Address - Zip Code:48653-8733
Practice Address - Country:US
Practice Address - Phone:989-821-9458
Practice Address - Fax:989-821-5566
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010174551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice