Provider Demographics
NPI:1962544338
Name:CHERRY FOURMAN DDS INC
Entity type:Organization
Organization Name:CHERRY FOURMAN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES OF CORP
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FOURMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:937-547-0114
Mailing Address - Street 1:138 SHAWNEE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331
Mailing Address - Country:US
Mailing Address - Phone:937-547-0114
Mailing Address - Fax:937-547-1526
Practice Address - Street 1:138 SHAWNEE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331
Practice Address - Country:US
Practice Address - Phone:937-547-0114
Practice Address - Fax:937-547-1526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty