Organization
CHARLES H MIDDLETON DDS PC
Active
Other names
Charles H Middleton & Mary Ellen Argus
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES H MIDDLETON DDS PC (OWNER)
(260) 484-3136
Entity
Organization
Contact information
Practice address
4302 E STATE BLVD, FORT WAYNE, IN 46815
(260) 484-3136
(260) 484-3137
Mailing address
4302 E STATE BLVD, FORT WAYNE, IN 46815
(260) 484-3136
(260) 484-3137
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00055165
UNITED CONCORDIA
IN
Enumeration date
10/06/2006
Last updated
04/30/2013
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