Individual
DR. BRIAN WILLIAM CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1003 N 3RD ST, MCCALL, ID 83638-3822
(208) 634-7653
(208) 634-4568
Mailing address
1003 N 3RD ST, MCCALL, ID 83638-3822
(208) 634-7653
(208) 634-4568
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D-1796
ID
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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