Provider Demographics
NPI:1578396081
Name:CERCHIARA, TERESA NICOLE (DMD)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:NICOLE
Last Name:CERCHIARA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 PENLEY LAKE CIR UNIT 304
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-1571
Mailing Address - Country:US
Mailing Address - Phone:301-395-3276
Mailing Address - Fax:
Practice Address - Street 1:541 SW PINE ISLAND RD
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33991-1962
Practice Address - Country:US
Practice Address - Phone:239-677-3795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL295381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice