Individual
CHARLES R FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MAGD
Contact information
Practice address
2101 ASPEN DR, MECHANICSBURG, PA 17055-5508
(717) 697-3400
(717) 697-7857
Mailing address
2101 ASPEN DR, MECHANICSBURG, PA 17055-5508
(717) 697-3400
(717) 697-7857
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
23655
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
731679
UNITED CONCORDIA PROVIDER
PA
Enumeration date
11/10/2006
Last updated
07/08/2007
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