Individual
DR. CHARLES L. PROESEL JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
205 E GRIDLEY RD, GRIDLEY, IL 61744-8733
(309) 747-2213
(309) 747-3989
Mailing address
PO BOX 288, GRIDLEY, IL 61744-0288
(309) 747-2213
(309) 747-3989
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
19A14491
IL
Other
Enumeration date
06/14/2005
Last updated
07/08/2007
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