Provider Demographics
NPI:1609327766
Name:BOISE, CHERYL M (RDH)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:M
Last Name:BOISE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 TYLER ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-2951
Mailing Address - Country:US
Mailing Address - Phone:603-880-4410
Mailing Address - Fax:
Practice Address - Street 1:19 TYLER ST
Practice Address - Street 2:SUITE 201
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-2951
Practice Address - Country:US
Practice Address - Phone:603-880-4410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH00935124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist