Individual
DR. CHARLES JACKSON VAN METER III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
300 MAXEY DR, BRANDON, MS 39042-2576
(601) 665-0411
Mailing address
300 MAXEY DR, BRANDON, MS 39042
(601) 665-0411
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0S466-13
MS
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
5853
LA
Other
Enumeration date
05/21/2008
Last updated
07/18/2013
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