Individual
DR. CHARLES VITTITOW III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2219 RIMLAND DR STE 110, BELLINGHAM, WA 98226-8661
(502) 523-3514
Mailing address
34800 BOB WILSON DR, SAN DIEGO, CA 92136-0001
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9591
KY
122300000X
Dentist
Primary
DE61005425
WA
390200000X
Student in an Organized Health Care Education/Training Program
9591
KY
Other
Enumeration date
07/09/2015
Last updated
08/11/2022
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