Organization
CHARLES WOHLWEND DDSPC
Active
Parent organization
CHARLES WOHLWEND DDSPC
Other names
Eagleridge Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHARLES WOHLWEND DDSPC
Authorized official
DR. CHARLES WOHLWEND DDS (DENTIST)
(719) 542-1212
Entity
Organization
Contact information
Practice address
104 E 6TH ST, WALSENBURG, CO 81089-2020
(719) 738-2544
(719) 738-3747
Mailing address
104 E 6TH ST, WALSENBURG, CO 81089-2020
(719) 738-2544
(719) 738-3747
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20
—
CO
Enumeration date
03/10/2020
Last updated
05/19/2020
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