Brian W Charles Dmd

NPI 1023324621 - Clinic/Center - 261QD0000X

NPI Details
NPI 1023324621
Enumeration Date 08/20/2010
Last Updated 08/20/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name BRIAN W BRIAN
Position OWNER
Phone (208) 634-7653
Fax (208) 634-4568
Practice Location
509 PINE ST
MCCALL ID, 83638-5017, US
Phone (208) 634-7653
Fax (208) 634-4568
Business Location
509 PINE ST
MCCALL ID, 83638-5017, US
Phone (208) 634-7653
Fax (208) 634-4568
Toxanomy
Taxonomy Code 261QD0000X
License State Idaho
License Number N-08582
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According to our database, Brian W Charles Dmd NPI is 1023324621, taxonomy code is 261QD0000X and license number is N-08582, license state is located at Idaho. Brian W Charles Dmd physically located at 509 Pine St, Mccall ID, 83638-5017. NPI Number 1033115704 has the healthcare provider type.

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1023324621 NPI number is provided on an as is basis without warranty of any kind. 1023324621 is maintained by the National Plan & Provider Enumeration System. The contents of Brian W Charles Dmd are for informational purposes only.