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Individual

CHARLES EDWIN FAULKNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
4041 HIGHWAY 90, PACE, FL 32571-1917
(850) 994-8185
Mailing address
4041 HIGHWAY 90, PACE, FL 32571-1917
(850) 994-8185

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN 18343
FL

Other

Enumeration date
06/23/2008
Last updated
06/23/2008
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