Individual
DR. CHARLES RICHARD HOLMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
208 BRADFORD LANE, WATERLOO, IL 62298
(618) 939-7181
(618) 939-4500
Mailing address
208 BRADFORD LANE, WATERLOO, IL 62298
(618) 939-7181
(618) 939-4500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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