Individual
CODY CHARRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
411 W MAIN ST, SHERIDAN, OR 97378-1117
(888) 468-0022
(541) 504-3907
Mailing address
442 SW UMATILLA AVE, SUITE 200, REDMOND, OR 97756-7039
(541) 504-3900
(541) 504-3907
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10299
OR
Other
Enumeration date
07/21/2015
Last updated
09/16/2015
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