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Provider Information for 1649206707



DR. CHARMEN W. DOUGLAS D.M.D

Gender: FEMALE

Individual NPI: 1649206707

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1649206707
Enumeration Date 2006-06-23
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 146 HADDONFIELD-BERLIN ROAD SUITE#302
GIBBSBORO, NJ 08026
United States

Phone: 856-346-8900 | Fax: 856-346-8866
View Map External Link
Primary Practice Address 146 HADDONFIELD BERLIN RD S SUITE#302
GIBBSBORO, NJ 08026-1018
United States

Phone: 856-346-8900 | Fax: 856-346-8866
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice NJ 22DI01738100