Organization
MIDDLETON FAMILY DENTISTRY LLC
Active
Other names
Charles H Middleton DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES H MIDDLETON DDS (OWNER)
(260) 484-3136
Entity
Organization
Contact information
Practice address
1234 E DUPONT RD STE 4, FORT WAYNE, IN 46825-1545
(260) 484-3136
Mailing address
1234 E DUPONT RD STE 4, FORT WAYNE, IN 46825-1545
(260) 484-3136
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12007605
IN
122300000X
Dentist
Primary
12008119
IN
122300000X
Dentist
12011467A
IN
Other
Enumeration date
08/19/2010
Last updated
08/19/2010
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