Individual
DR. CHARLES J. EDELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
425 W RUSSELL RD, SIDNEY, OH 45365-1454
(937) 492-2848
(937) 492-8615
Mailing address
425 W RUSSELL RD, SIDNEY, OH 45365-1454
(937) 492-2848
(937) 492-8615
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30017977
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0829170
—
OH
Enumeration date
01/23/2007
Last updated
07/08/2007
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