Provider Demographics
NPI:1104205822
Name:CHERI W CUNNINGHAM DMD
Entity Type:Organization
Organization Name:CHERI W CUNNINGHAM DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:W
Authorized Official - Last Name:CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-285-9661
Mailing Address - Street 1:907 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-2633
Mailing Address - Country:US
Mailing Address - Phone:205-285-9661
Mailing Address - Fax:205-285-9663
Practice Address - Street 1:907 MAIN ST
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-2633
Practice Address - Country:US
Practice Address - Phone:205-285-9661
Practice Address - Fax:205-285-9663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5328122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty