| Organization Name: | CHERRY STREET SERVICES INC |
| NPI Number: | 1184015539 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHRIS SHEA (CEO) |
| Mailing Address: | 204 E Muskegon St Cedar Springs |
| State: | MI US |
| Postal Code: | 493199326 |
| Phone Number: | 6166967330 |
| Fax Number: | 6166963123 |
| NPI Enumeration Date: | 02/06/2015 |
| NPI Last Update Date: | 06/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |