Provider Demographics
NPI:1598972200
Name:CHERRY, .THOMAS D (DDS, MSD, PC)
Entity type:Individual
Prefix:DR
First Name:.THOMAS
Middle Name:D
Last Name:CHERRY
Suffix:
Gender:M
Credentials:DDS, MSD, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 HAMMOND DR NE
Mailing Address - Street 2:SUITE B-2240
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5334
Mailing Address - Country:US
Mailing Address - Phone:770-668-9725
Mailing Address - Fax:770-668-9726
Practice Address - Street 1:1150 HAMMOND DR NE
Practice Address - Street 2:SUITE B-2240
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5334
Practice Address - Country:US
Practice Address - Phone:770-668-9725
Practice Address - Fax:770-668-9726
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA101221223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics