# CHARLES CLAUSEN DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245410232
- **Authorized official:** THERESA M WHITE (MANAGER)
- **Authorized official phone:** (623) 848-0100

## Contact information

- **Practice address:** 13055 W MCDOWELL, \#G103, AVONDALE, AZ 85392
- **Practice address phone:** (623) 848-0100
- **Practice address fax:** (623) 848-3516
- **Mailing address:** 13055 W MCDOWELL, \#G103, AVONDALE, AZ 85392
- **Mailing address phone:** (623) 848-0100
- **Mailing address fax:** (623) 848-3516

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 3245 | AZ | Yes |

## Other

- **Enumeration date:** 11/07/2007
- **Last updated:** 11/07/2007