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General NPI Number Information
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NPI Number | 1881032993
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Entity Type | Individual
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Provider Name | CHARLES WILLIAM DREXLER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/11/2013
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 4315 HENDERSON BLVD
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City | TAMPA
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State | FL
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Zip | 33629-5612
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Country | US
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Telephone | 813-358-7110
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Fax |
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Provider Business Mailing Address
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Address Line | 7500 21ST ST N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33702-4820
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Country | US
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Telephone | 972-213-5446
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 25613
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 25613
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 28904
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License Number State | TX
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