| NPI | 1083785869 |
|---|---|
| Former Name | CHERYL LYNN MADEJCZYK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CO 00202315) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 5071) |
| 122300000X Dentist (Licence: WA DE00011173) | |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2016-02-16 |