Provider Demographics
NPI:1417108820
Name:CHEEK, RENCE (CLARENCE) F JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:RENCE (CLARENCE)
Middle Name:F
Last Name:CHEEK
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 LOVERS LN
Mailing Address - Street 2:
Mailing Address - City:HAWKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31036-4904
Mailing Address - Country:US
Mailing Address - Phone:478-783-3390
Mailing Address - Fax:478-783-3381
Practice Address - Street 1:23 LOVERS LN
Practice Address - Street 2:
Practice Address - City:HAWKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:31036-4904
Practice Address - Country:US
Practice Address - Phone:478-783-3390
Practice Address - Fax:478-783-3381
Is Sole Proprietor?:No
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0111911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice