# CHERRY ORCHARD PEDIATRIC DENTISTRY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225615156
- **Authorized official:** LISA CHERRY DDS (PEDIATRIC DENTIST)
- **Authorized official phone:** (864) 603-2603

## Contact information

- **Practice address:** 101 HALTON RD STE B, GREENVILLE, SC 29607-3507
- **Practice address phone:** (864) 603-2603
- **Practice address fax:** (864) 603-2606
- **Mailing address:** 106 SHAMROCK LN, GREENVILLE, SC 29615-5462
- **Mailing address phone:** (864) 423-4129

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 03/26/2021
- **Last updated:** 12/06/2023