Individual
MR. CHARLES KEITH FUQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2444 S DETROIT AVE, C KEITH FUGUA DDS, MAUMEE, OH 43537
(419) 893-8431
(419) 893-7234
Mailing address
2444 S DETROIT AVE, C KEITH FUGUA DDS, MAUMEE, OH 43537
(419) 893-8431
(419) 893-7234
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14255
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0227150
—
OH
Enumeration date
11/20/2006
Last updated
12/11/2012
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