Individual
CHARLES WILLIAM DORMAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
4637 QUAIL LAKES DR, STOCKTON, CA 95207-5258
(209) 235-7207
(209) 235-7210
Mailing address
4637 QUAIL LAKES DR, STOCKTON, CA 95207-5258
(209) 235-7207
(209) 235-7210
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
22339
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22339
CA. DENTAL LICENSE NUMBER
CA
Enumeration date
11/21/2006
Last updated
07/08/2007
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