Individual
DR. CHARLES LEO STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4089 VAL TECH RD, WIREGRASS GEORGIA TECHNICAL COLLEGE, BERRIEN HALL, VALDOSTA, GA 31602-0929
(229) 245-3716
(229) 245-6513
Mailing address
4089 VAL TECH RD, WIREGRASS GEORGIA TECHNICAL COLLEGE, BERRIEN HALL, VALDOSTA, GA 31602-0929
(229) 245-3716
(229) 245-6513
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN009783
GA
Other
Enumeration date
01/26/2012
Last updated
01/26/2012
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