Individual
DR. TRACEY ROSEANN CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
9345 CALYPSO TRAIL NW, BEMIDJI, MN 56601
(218) 679-3912
(218) 679-0181
Mailing address
9345 CALYPSO TRAIL NW, BEMIDJI, MN 56601
(218) 679-3912
(218) 679-0181
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
8119
TN
Other
Enumeration date
11/03/2006
Last updated
07/08/2007
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