Individual
DR. CHARLES LEONARD WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1200 VICTOR II BLVD, MORGAN CITY, LA 70380-1350
(985) 384-0926
(985) 384-6754
Mailing address
PO BOX 1910, MORGAN CITY, LA 70381-1910
(985) 384-0926
(985) 384-6754
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1671
LA
Other
Enumeration date
10/26/2006
Last updated
07/08/2007
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