Individual
CHARLES RANDALL MORITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS PC
Contact information
Practice address
2704 N OAK ST, SUITE C-1, VALDOSTA, GA 31602-1744
(229) 247-0200
(229) 247-0200
Mailing address
2704 N OAK ST, SUITE C-1, VALDOSTA, GA 31602-1744
(229) 247-0200
(229) 247-0200
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0008063
GA
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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