Individual
DR. CHARLES WALTER PATTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2876 N PINAL AVE STE 4, CASA GRANDE, AZ 85122-7944
(520) 374-2225
(520) 374-2229
Mailing address
515 CHAMBERLAIN LN UNIT 209, NAPERVILLE, IL 60540-9289
(630) 210-5419
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D010589
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D010589
DENTAL LICENSE
AZ
Enumeration date
12/22/2005
Last updated
09/28/2020
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