Charles Milton Waller D.D.S.

NPI 1861528929 - Dentist - 1223G0001X

NPI Details
NPI 1861528929
Gender Male
Enumeration Date 02/25/2007
Last Updated 12/31/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
272 BLUE HAVEN BEACH RD
CAMDENTON MO, 65020-2123, US
Phone (573) 873-5111
Fax (573) 873-5111
Business Location
272 BLUE HAVEN BEACH RD
CAMDENTON MO, 65020-2123, US
Phone (573) 873-5111
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Missouri
License Number 2002029904
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According to our database, Dr. Charles Milton Waller D.D.S. NPI is 1861528929, taxonomy code is 1223G0001X and license number is 2002029904, license state is located at Missouri. Charles Milton Waller D.D.S. physically located at 272 Blue Haven Beach Rd, Camdenton MO, 65020-2123. NPI Number Charles Milton Waller D.D.S. has the Individual type.

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1861528929 NPI number is provided on an as is basis without warranty of any kind. 1861528929 is maintained by the National Plan & Provider Enumeration System. The contents of Charles Milton Waller D.D.S. are for informational purposes only.