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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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