Provider Demographics
NPI:1902015571
Name:DOUMAR, CHERYL ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:ANN
Last Name:DOUMAR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 COPPS HILL RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4050
Mailing Address - Country:US
Mailing Address - Phone:203-431-4344
Mailing Address - Fax:203-431-3236
Practice Address - Street 1:63 COPPS HILL RD
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4050
Practice Address - Country:US
Practice Address - Phone:203-431-4344
Practice Address - Fax:203-431-3236
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6014122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist