Individual
CHARLES PRESTON POOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4101 TULLY RD STE 201, MODESTO, CA 95356-8981
(209) 577-0777
(209) 572-3845
Mailing address
3608 DALE RD, MODESTO, CA 95356-0500
(209) 577-0777
(209) 577-0885
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
100373
CA
1223G0001X
General Practice Dentistry
Primary
9142
SC
Other
Enumeration date
11/21/2016
Last updated
12/27/2018
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