Middleton, Charles H

Middleton, Charles H is an individual health care provider with primary practice located at 4302 E State Blvd , Fort Wayne IN 46815-6988. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Middleton, Charles H can be contacted via phone (260) 484-3136.

Contact Information

Primary practice address
4302 E State Blvd Fort Wayne IN 46815-6988
Phone: (260) 484-3136
Fax: (260) 484-3137
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 12008119 Indiana

Profile Details

NPI number 1093902264
LBN Legal business name Middleton, Charles H
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 1st, 2007
Last updated Mar 31st, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093902264 NPPES
Indiana MEDICAID 100079660A
Indiana Other 000055165

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