Charles Wesley Ketcham, D.D.S. Valid NPI
Individual provider · General Practice Dentistry · Thousand Oaks, CA
- NPI
- 1174667216
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 23839 (CA)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2007-02-19
- Last updated
- 2007-07-08
Practice location
228 Lombard St Ste C
Thousand Oaks, CA 91360-8202
(805) 496-3209