Provider Demographics
NPI:1295959559
Name:CHERRY, MARTI L (DDS,PA)
Entity type:Individual
Prefix:DR
First Name:MARTI
Middle Name:L
Last Name:CHERRY
Suffix:
Gender:M
Credentials:DDS,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 W. ARROWOOD RD.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273
Mailing Address - Country:US
Mailing Address - Phone:704-831-6349
Mailing Address - Fax:704-831-6352
Practice Address - Street 1:2620 W. ARROWOOD RD.
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273
Practice Address - Country:US
Practice Address - Phone:704-831-6349
Practice Address - Fax:704-831-6352
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC74161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice