Individual
MR. CHARLES OAKLEY COULTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2230 TOWNE LAKE PARKWAY, BUILDING 1300 SUITE 100, WOODSTOCK, GA 30189
(678) 445-5444
(678) 445-5552
Mailing address
PO BOX 195, WOODSTOCK, GA 30188
(678) 445-5444
(678) 445-5552
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
0401414164
VA
1223P0221X
Pediatric Dentistry
Primary
14922
MD
1223P0221X
Pediatric Dentistry
35438
TX
1223P0221X
Pediatric Dentistry
DEN1001274
DC
1223P0221X
Pediatric Dentistry
DN013607
GA
Other
Enumeration date
03/19/2007
Last updated
12/16/2020
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