Individual
CHARLES CALDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
3875 BURTON ST SE, GRAND RAPIDS, MI 49546-5816
(616) 949-7510
(616) 949-6051
Mailing address
3875 BURTON ST SE, GRAND RAPIDS, MI 49546-5816
(616) 949-7510
(616) 949-6051
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2901011536
MI
Other
Enumeration date
04/03/2007
Last updated
07/08/2007
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