Organization
CHARLES R DISDIER DDS PA
Active
Other names
Immediate Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES R DISDIER DDS (DENTIST)
(252) 243-8448
Entity
Organization
Contact information
Practice address
1468 TARBORO ST W, SUITE F, WILSON, NC 27893-1509
(252) 243-8448
(252) 243-9503
Mailing address
1468 TARBORO ST W, SUITE F, WILSON, NC 27893-1509
(252) 243-8448
(252) 243-9503
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6975
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5901593
—
NC
Enumeration date
02/13/2007
Last updated
06/18/2008
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