Provider Demographics
NPI:1417151747
Name:DR. CHERRYL A. DAVIS
Entity Type:Organization
Organization Name:DR. CHERRYL A. DAVIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERRYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-247-4900
Mailing Address - Street 1:316 COMMERCE AVENUE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557
Mailing Address - Country:US
Mailing Address - Phone:252-247-4900
Mailing Address - Fax:252-247-4935
Practice Address - Street 1:316 COMMERCE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-3283
Practice Address - Country:US
Practice Address - Phone:252-247-4900
Practice Address - Fax:252-247-4935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC66231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty