Provider Demographics
NPI:1649344169
Name:FARMER, CHERAE MONTALISA (DDS)
Entity type:Individual
Prefix:DR
First Name:CHERAE
Middle Name:MONTALISA
Last Name:FARMER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHERAE
Other - Middle Name:MONTALISA
Other - Last Name:FARMER-DIXON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1421 TIMBER VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-4324
Mailing Address - Country:US
Mailing Address - Phone:615-351-0551
Mailing Address - Fax:615-327-6074
Practice Address - Street 1:3803 HYDES FERRY RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37218-2645
Practice Address - Country:US
Practice Address - Phone:615-244-5269
Practice Address - Fax:615-327-6074
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5300122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist