| NPI | 1790842375 |
|---|---|
| Doing Business As | CHERRY RIDGE DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | LAWRENCE GLEN CARUTH President Owner 570-253-4245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA 015861) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2020-08-22 |