Provider Demographics
NPI:1750305827
Name:CHERRY, WILLIAM FREDRICK II (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FREDRICK
Last Name:CHERRY
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2426 SOUTH CARRIER PARKWAY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-8506
Mailing Address - Country:US
Mailing Address - Phone:972-641-8415
Mailing Address - Fax:
Practice Address - Street 1:2426 SOUTH CARRIER PARKWAY
Practice Address - Street 2:SUITE 102
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-8506
Practice Address - Country:US
Practice Address - Phone:972-641-8415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice