Provider Demographics
NPI:1164501045
Name:REYGERS, CHERYL EILEEN (DDS)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:EILEEN
Last Name:REYGERS
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 1:122 TOMPKINS STREET
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045
Mailing Address - Country:US
Mailing Address - Phone:607-758-3695
Mailing Address - Fax:607-758-3158
Practice Address - Street 1:122 TOMPKINS STREET
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045
Practice Address - Country:US
Practice Address - Phone:607-756-4574
Practice Address - Fax:607-758-3158
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0411211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice