Individual
DR. CHARLES G BODE
Active
Individual
DR. CHARLES G BODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2579
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
082115
CMDP
AZ
01
—
823999
UNITED CONCORDIA
AZ
01
—
AZ0116750
BCBS
AZ
Enumeration date
09/13/2006
Last updated
07/08/2007
Update your record
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