Organization
CHARLES R PAYERLE, DDS, MD, PLLC
Active
Organization
CHARLES R PAYERLE, DDS, MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES R PAYERLE DDS, MD, LLC (OWNER)
(817) 568-6811
Entity
Organization
Contact information
Practice address
12001 SOUTH FWY, SUITE 207, BURLESON, TX 76028-7208
(817) 568-6811
(817) 568-6813
Mailing address
12001 SOUTH FWY, SUITE 207, BURLESON, TX 76028-7208
(817) 568-6811
(817) 568-6813
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0023735
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780894170
NPI
—
Enumeration date
04/09/2010
Last updated
04/09/2010
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