Provider Demographics
NPI:1639106057
Name:SIEGEL, CHERYL A (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:A
Last Name:SIEGEL
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 1:4505 FAIR MEADOWS LN
Mailing Address - Street 2:209
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6465
Mailing Address - Country:US
Mailing Address - Phone:919-881-9258
Mailing Address - Fax:919-881-9637
Practice Address - Street 1:4505 FAIR MEADOWS LN
Practice Address - Street 2:209
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6465
Practice Address - Country:US
Practice Address - Phone:919-881-9258
Practice Address - Fax:919-881-9637
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5679122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist