Individual
DR. CHARLES W HETRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
218 E 10TH STREET PLZ, EDMOND, OK 73034-4737
(405) 341-7046
Mailing address
218 E 10TH STREET PLZ, EDMOND, OK 73034-4737
(405) 341-7046
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4032
OK
Other
Enumeration date
05/17/2007
Last updated
01/11/2019
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