Individual
DR. CHARLES BONNER OATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
210 NEEL AVE, SOCORRO, NM 87801-4649
(505) 835-1623
(505) 835-3033
Mailing address
210 NEEL AVE, SOCORRO, NM 87801-4649
(505) 835-1623
(505) 835-3033
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD1385
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00084517
—
NM
05
—
6465
—
NM
Enumeration date
03/15/2007
Last updated
07/09/2007
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