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General NPI Number Information
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NPI Number | 1144375247
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Entity Type | Organization
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Legal Business Name | CHARLES R. INGLE DDS,PS
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 07/28/2008
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Provider Practice Location Address
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Address Line | 14300 SE PETROVITSKY RD
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City | RENTON
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State | WA
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Zip | 98058-8955
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Country | US
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Telephone | 425-226-2348
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Fax |
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Provider Business Mailing Address
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Address Line | 14300 SE PETROVITSKY RD
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City | RENTON
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State | WA
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Zip | 98058-8955
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Country | US
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Telephone | 425-226-2348
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHARLES ROEMER INGLE
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Credential | DDS
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Telephone | 425-226-2348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4358
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License Number State | WA
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