Individual
DR. CHARLES WESLEY MAGNUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1331 CHIMES BLVD, SOUTH BEND, IN 46615-3549
(574) 232-2047
(574) 232-3252
Mailing address
1331 CHIMES BLVD, SOUTH BEND, IN 46615-3549
(574) 232-2047
(574) 232-3252
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
IN8114
IN
Other
Enumeration date
03/10/2007
Last updated
07/08/2007
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