Individual
CHARLES FREDERICK CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
202 S ELDORADO RD, BLOOMINGTON, IL 61704-4471
(309) 663-6551
(309) 663-2578
Mailing address
202 S ELDORADO RD, BLOOMINGTON, IL 61704-4471
(309) 663-6551
(309) 663-2578
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
01/03/2007
Last updated
07/08/2007
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