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Individual

DR. CHARLES HENRY DETJEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
3245 HOSPITAL DR, JUNEAU, AK 99801
(907) 463-4016
(907) 463-4032
Mailing address
9349 LAKEVIEW CT, JUNEAU, AK 99801
(907) 790-2042

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901015545
MI

Other

Enumeration date
12/22/2006
Last updated
07/08/2007
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