Organization
CHERRY LANE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ANDREW BERGLOFF D.D.S. (PRESIDENT)
(208) 888-7889
Entity
Organization
Contact information
Practice address
1104 W CHERRY LN, MERIDIAN, ID 83642-1513
(208) 888-7889
Mailing address
1104 W CHERRY LN, MERIDIAN, ID 83642-1513
(208) 888-7889
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
D-3409
ID
Other
Enumeration date
05/25/2006
Last updated
08/22/2020
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