Organization
CHARLES COLE D.D.S LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES F COLE DDS (DENTIST/OWNER)
(907) 631-3630
Entity
Organization
Contact information
Practice address
1830 E PARKS HWY, A134, WASILLA, AK 99654-7378
(907) 631-3630
Mailing address
1830 E PARKS HWY, SUITE A134, WASILLA, AK 99654
(907) 631-3630
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
628
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DD0007
—
AK
Enumeration date
05/14/2013
Last updated
05/14/2013
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