Individual
DR. CHARLES LEE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2240 E WINDROW AVE, FORT HUACHUCA, AZ 85613-7040
(719) 355-6674
Mailing address
2240 E WINDROW AVE, FORT HUACHUCA, AZ 85613-7040
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12011960A
IN
Other
Enumeration date
07/02/2013
Last updated
05/14/2019
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