Individual
DR. CHARLES J. HARRELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
139 S MAIN ST, PETAL, MS 39465-2331
(601) 584-9481
(601) 544-5161
Mailing address
139 S MAIN ST, PETAL, MS 39465-2331
(601) 584-9481
(601) 544-5161
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2549-90
MS
Other
Enumeration date
10/11/2006
Last updated
07/08/2007
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