Individual
DR. CHARLES NOEL KIDROSKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2041 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-5147
(336) 777-1272
(336) 777-1196
Mailing address
2041 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-5147
(336) 777-1272
(336) 777-1196
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8237
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5905598
—
NC
01
—
903AW
BLUE CROSS BLUE SHEILD NC
NC
Enumeration date
07/27/2006
Last updated
05/09/2013
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