Individual
DR. THOMAS D CHARBENEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSD, PA
Contact information
Practice address
3420 CLARKSVILLE ST, PARIS, TX 75460-8014
(903) 785-4832
(903) 785-3807
Mailing address
3420 CLARKSVILLE ST, P.O. BOX 6578, PARIS, TX 75460-8014
(903) 785-4832
(903) 785-3807
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
11554
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568474989
CORPORATION
TX
Enumeration date
08/06/2007
Last updated
08/06/2007
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