Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. CHARLES L. PROESEL JR., D.D.S.
ActiveDental Public Health · GRIDLEY, IL
Registration Details
- NPI Number
- 1972508364
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 14, 2005 (20.853964333707 yrs)
- Last Updated
- Jul 8, 2007
- License
-
19A14491 (IL)
Practice Information
- Address
-
205 E GRIDLEY RDGRIDLEY, IL, 617448733Browse IL providers · Browse ZIP 61744
- Phone
- 3097472213
- Fax
- 3097473989
- Primary Specialty
-
Dental Public Health
1223D0001X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.