Colton Charles, DMD Valid NPI
Individual provider · General Practice Dentistry · Eagle, ID
- NPI
- 1073826772
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- D4320 (ID)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2010-07-22
- Last updated
- 2020-06-17
Practice location
450 W State St Ste 180
Eagle, ID 83616-6974
(208) 939-0600