Individual
DR. CHARLES H. VANDERPOOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
HWY 264 AND JUNCTION 191 S, GANADO, AZ 86505
(928) 755-4500
(928) 755-4815
Mailing address
PO BOX 457, GANADO, AZ 86505-0457
(928) 755-4500
(928) 755-4815
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D2521
AZ
Other
Enumeration date
06/23/2008
Last updated
06/23/2008
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