Healthcare Provider Details

I. General information

NPI: 1801936281
Provider Name (Legal Business Name): CHARLES J. VEITH, DMD, MS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 PENNSYLVANIA AVE SUITE 5C
WILMINGTON DE
19806-1392
US

IV. Provider business mailing address

2300 PENNSYLVANIA AVE SUITE 5C
WILMINGTON DE
19806-1392
US

V. Phone/Fax

Practice location:
  • Phone: 302-658-7354
  • Fax: 302-658-7356
Mailing address:
  • Phone: 302-658-7354
  • Fax: 302-658-7356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberG-1000612
License Number StateDE

VIII. Authorized Official

Name: MRS. KATHY M CLOUGH
Title or Position: OFFICE MANAGER
Credential:
Phone: 302-658-7354