Individual
DR. CHARLES AUSTIN BIRCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1575 SKYLYN DR, SPARTANBURG, SC 29307-1034
(864) 699-9193
Mailing address
1575 SKYLYN DR, SPARTANBURG, SC 29307-1034
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
4059
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z4059
—
SC
Enumeration date
05/31/2006
Last updated
06/20/2014
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