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Cherry Lane Dental — NPI 1083660021, Meridian, ID | NPI Central

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NPI 1083660021

OrganizationActive

Cherry Lane Dental

NPI 1083660021 · Point of Service · Meridian, ID

Provider details

NPI number: 1083660021
Entity type: Organization
Primary specialty: Point of ServiceManaged Care Organizations
Organization subpart: No
Authorized official: John Bergloff, President(208) 888-7889
License: D-3409 (ID)

Specialties & taxonomies

Point of ServicePrimary305S00000XLicense D-3409 (ID)
Managed Care Organizations

Practice location

1104 W Cherry Ln

Meridian, ID 83642-1513

Phone: (208) 888-7889

Approximate (ZIP-level) locationGet directions

More ID providers

Mailing address

1104 W Cherry Ln

Meridian, ID 83642-1513

Registry dates

Enumerated: 2006-05-25
Last updated: 2020-08-22

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.