Individual
DR. CHARLES DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
9761 S COTTAGE GROVE AVE, CHICAGO, IL 60628-1510
(773) 721-7799
(773) 721-3719
Mailing address
9761 SOUTH COTTAGE GROVE AVE., CHICAGO, IL 60628-1510
(773) 721-7799
(773) 721-3719
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
03190169751
IL
Other
Enumeration date
10/16/2009
Last updated
10/16/2009
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