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Individual

DR. CHARLES F DEFREEST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS, FACP

Contact information

Practice address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(210) 292-8488
(210) 292-6431
Mailing address
133 LABURNUM DR, SAN ANTONIO, TX 78209-2121
(210) 865-5035

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
30324
CA

Other

Enumeration date
05/08/2006
Last updated
02/12/2021
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