Individual
CHARLES R SODERQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8383 W BELMONT AVENUE, SUITE 200, RIVER GROVE, IL 60171-1083
(708) 453-1110
(708) 452-0157
Mailing address
8383 W BELMONT AVENUE, SUITE 200, RIVER GROVE, IL 60171-1083
(708) 453-1110
(708) 452-0157
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
10/14/2006
Last updated
07/08/2007
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