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Brian W Charles Dmd
Dental Clinic/Center in Mccall, Idaho
NPI 1023324621

Brian W Charles Dmd is a Dental Clinic/Center based in Mccall, ID and is specialized in Dental. Brian W Charles Dmd practices in Mccall, ID. The NPI Number for Brian W Charles Dmd is 1023324621 and holds a License No. N-08582 (Idaho).

The current practice location address for Brian W Charles Dmd is 509 Pine St, Mccall, ID and can be reached out via phone at 208-634-7653 and via fax at 208-634-4568.

Location: 509 Pine St, Mccall, ID, 83638-5017
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1023324621
Provider Name
Brian W Charles Dmd
Credential
Provider Entity Type
Organization
Address
509 Pine St, Mccall, ID, 83638-5017
Phone Number
208-634-7653
Fax Number
208-634-4568
Provider Enumeration Date
08/20/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
002547300 05 ID
institution
Provider Business Practice Location Address Details
Address
509 Pine St
City
Mccall
State
Idaho
Zip
83638-5017
Phone Number
208-634-7653
Fax Number
208-634-4568
person
Provider Business Mailing Address Details
Address
509 Pine St
City
Mccall
State
Idaho
Zip
83638-5017
Phone Number
208-634-7653
Fax Number
208-634-4568
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
N-08582 (Idaho)
Definition
Definition to come...
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