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NPI Code Detail

MEDICARE: CHARLES E WAIT DDS

MEDICARE:   CHARLES E WAIT  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry0021228AZ

General Provider Information

NPI Number : 1245496595
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES E WAIT DDS
Provider Business Mailing Address
First Line : 10629 N 71ST PL
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85254-5273
Country : US
Telephone Number : 480-998-1188
Fax Number : 480-948-0516
Provider Business Practice Location Address
First Line : 10629 N 71ST PL
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85254-5273
Country : US
Telephone Number : 480-998-1188
Fax Number : 480-948-0516
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2008
Last Update Date : 08/05/2008

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Directions to “ CHARLES E WAIT DDS” Practice Location

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