Individual
DR. CARL WILLIAM CHURCHMAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3425 LOUISIANA AVENUE, LAKE CHARLES, LA 70607-1851
(337) 477-5043
(337) 477-5085
Mailing address
3425 LOUISIANA AVENUE, LAKE CHARLES, LA 70607-1851
(337) 477-5043
(337) 477-5085
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5557
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1855570
—
LA
Enumeration date
10/24/2006
Last updated
07/08/2007
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