Individual
DR. CHARLES PASCHAL BROOKS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
13762 MAGNOLIA ST, BLAKELY, GA 39823-1875
(229) 723-4111
(229) 723-6083
Mailing address
PO BOX 707, BLAKELY, GA 39823-0707
(229) 723-4111
(229) 723-6083
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN014123
GA
Other
Enumeration date
07/01/2010
Last updated
10/23/2012
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