# MIDDLETON FAMILY DENTISTRY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Charles H Middleton DDS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952617664
- **Authorized official:** DR. CHARLES H MIDDLETON DDS (OWNER)
- **Authorized official phone:** (260) 484-3136

## Contact information

- **Practice address:** 1234 E DUPONT RD STE 4, FORT WAYNE, IN 46825-1545
- **Practice address phone:** (260) 484-3136
- **Mailing address:** 1234 E DUPONT RD STE 4, FORT WAYNE, IN 46825-1545
- **Mailing address phone:** (260) 484-3136

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12007605 | IN | — |
| 122300000X | Dentist | 12008119 | IN | Yes |
| 122300000X | Dentist | 12011467A | IN | — |

## Other

- **Enumeration date:** 08/19/2010
- **Last updated:** 08/19/2010