Individual
DR. CHARLES EDWARD PECHOUS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6124 SHERIDAN RD, KENOSHA, WI 53143-4527
(262) 654-2423
Mailing address
7202 3RD AVE, KENOSHA, WI 53143-5561
(262) 764-0261
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
4535 - 015
WI
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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