Individual
DR. CHARLES WYLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1589 WHEELING AVE, GLEN DALE, WV 26038-1731
(304) 845-2480
(304) 845-9204
Mailing address
1589 WHEELING AVE, GLEN DALE, WV 26038-1731
(304) 845-2480
(304) 845-9204
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
WV2926
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0133399000
—
WV
Enumeration date
08/11/2006
Last updated
07/09/2007
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