# CHARLES L. WYLIE DDS GROUP

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

## Provider details

- **NPI number:** 1356557706
- **Authorized official:** DR. CHARLES L WYLIE DDS (DR)
- **Authorized official phone:** (304) 845-2480

## Contact information

- **Practice address:** 1589 WHEELING AVE, GLEN DALE, WV 26038-1731
- **Practice address phone:** (304) 845-2480
- **Mailing address:** 1589 WHEELING AVE, GLEN DALE, WV 26038-1731
- **Mailing address phone:** (304) 845-2480

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | WV2926 | WV | Yes |

## Other

- **Enumeration date:** 05/15/2007
- **Last updated:** 08/22/2020