Individual
DR. CHARLES RAYMOND MEHLE JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
310 MISSISSIPPI AVE, BOGALUSA, LA 70427-3850
(985) 735-9811
(985) 735-0064
Mailing address
310 MISSISSIPPI AVE, BOGALUSA, LA 70427-3850
(985) 735-9811
(985) 735-0064
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3312
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1833126
—
LA
Enumeration date
03/15/2006
Last updated
07/08/2007
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