Individual
DR. CHARLES EDWARD DALEY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
401 W MAIN ST, SUITE 104, LEBANON, TN 37087-3584
(615) 444-9611
(615) 444-9835
Mailing address
401 W MAIN ST, SUITE 104, LEBANON, TN 37087-3584
(615) 444-9611
(615) 444-9835
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DS0000007841
TN
Other
Enumeration date
10/06/2006
Last updated
07/08/2007
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