Individual
DR. CHARLES JOSEPH PORTALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2101 MAUREL DRIVE, CONROE, TX 77304
(936) 494-0200
(936) 494-2189
Mailing address
11 WEDGEWOOD BLVD, CONROE, TX 77304-1349
(936) 441-6079
(936) 756-6902
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19018
TX
Other
Enumeration date
10/16/2006
Last updated
07/08/2007
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