Individual
DR. CHARLES KEITH DIDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5637 N PALM AVE APT B, FRESNO, CA 93704-1829
(559) 246-0469
Mailing address
5637 N PALM AVE APT B, FRESNO, CA 93704-1829
(559) 246-0469
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
20174
CA
Other
Enumeration date
12/28/2018
Last updated
12/28/2018
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