Organization
CHARLES O. DU BOIS, D.D.S. LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES OSCAR DU BOIS D.D.S. (OWNER)
(740) 439-2962
Entity
Organization
Contact information
Practice address
65015 OLD 21 RD, CAMBRIDGE, OH 43725-9621
(740) 439-2962
(740) 439-0502
Mailing address
65015 OLD 21 RD, CAMBRIDGE, OH 43725-9621
(740) 439-2962
(740) 439-0502
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30. 021017
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2164410
—
OH
Enumeration date
06/11/2008
Last updated
06/11/2008
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