Individual
CHARLES DIETRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5028 WISCONSIN AVE NW, SUITE 102, WASHINGTON, DC 20016-4118
(202) 363-6177
Mailing address
5028 WISCONSIN AVE NW, SUITE 102, WASHINGTON, DC 20016-4118
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
6399
MD
1223G0001X
General Practice Dentistry
Primary
DEN 3288
DC
Other
Enumeration date
05/30/2009
Last updated
05/30/2009
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