Provider Demographics
NPI:1659537769
Name:ROQUE, CHERI KAY (DMD)
Entity Type:Individual
Prefix:
First Name:CHERI
Middle Name:KAY
Last Name:ROQUE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:CHERI
Other - Middle Name:KAY
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:10213 N 92ND ST STE H-102
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4561
Mailing Address - Country:US
Mailing Address - Phone:480-422-4544
Mailing Address - Fax:
Practice Address - Street 1:10213 N 92ND ST STE H-102
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4561
Practice Address - Country:US
Practice Address - Phone:480-422-4544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ79401223P0221X
NY0539711223P0221X
TN97741223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry