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General NPI Number Information
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NPI Number | 1699883660
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Entity Type | Individual
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Provider Name | CHARLES ROEMER INGLE DDS
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/08/2007
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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 | 425-226-2188
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Provider Business Mailing Address
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Address Line | 12610 SE 282ND ST
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City | KENT
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State | WA
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Zip | 98030
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Country | US
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Telephone | 253-630-5370
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4338
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License Number State | WA
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