Individual
DR. CHARLES W BRISCOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7737 HERSCHEL AVE, LA JOLLA, CA 92037-4406
(858) 454-3221
Mailing address
7737 HERSCHEL AVE, LA JOLLA, CA 92037-4406
(858) 454-3221
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
29214
CA
Other
Enumeration date
09/21/2012
Last updated
09/21/2012
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