Organization
CHARMING SMILES PC
Active
Other names
Fayette Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES LEE D.D.S. (PRESIDENT)
(563) 425-4211
Entity
Organization
Contact information
Practice address
143 S MAIN ST, FAYETTE, IA 52142-7701
(563) 425-4211
Mailing address
143 S MAIN ST, FAYETTE, IA 52142-7701
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
08790
IA
Other
Enumeration date
03/14/2012
Last updated
03/14/2012
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