# C W BARTHOLOMEW, DDS, PC

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

## Provider details

- **NPI number:** 1568813640
- **Authorized official:** DR. CHARLES W BARTHOLOMEW JR. DDS (PRACTICE OWNER)
- **Authorized official phone:** (765) 453-0291

## Contact information

- **Practice address:** 3415 S LAFOUNTAIN ST, SUITE C, KOKOMO, IN 46902-3802
- **Practice address phone:** (765) 453-0291
- **Mailing address:** 3415 S LAFOUNTAIN ST, SUITE C, KOKOMO, IN 46902-3802
- **Mailing address phone:** (765) 453-0291

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 12009183B | IN | Yes |

## Other

- **Enumeration date:** 06/29/2016
- **Last updated:** 06/29/2016