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Individual

DR. CHARLES ROBERT FAHNCKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.S.

Contact information

Practice address
3000 ARLINGTON AVE, MAIL STOP 1092, TOLEDO, OH 43614-2595
(419) 383-3776
Mailing address
6038 WHITE EAGLE W, SYLVANIA, OH 43560-9599
(419) 824-2108

Taxonomy

Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
2901016846
MI
1223P0700X
Prosthodontics
Primary
30-01-9124
OH

Other

Enumeration date
11/16/2006
Last updated
02/23/2011
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