Provider Demographics
NPI:1083027858
Name:STRAUGHAN, CHARLES ARMSWORTHY (DMD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:ARMSWORTHY
Last Name:STRAUGHAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BLYTHE BLVD
Mailing Address - Street 2:CMC DENTAL CLINIC
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203-5812
Mailing Address - Country:US
Mailing Address - Phone:704-355-4197
Mailing Address - Fax:704-355-5301
Practice Address - Street 1:1000 BLYTHE BLVD
Practice Address - Street 2:CMC DENTAL CLINIC
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28203-5812
Practice Address - Country:US
Practice Address - Phone:704-355-4197
Practice Address - Fax:704-355-5301
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCAC5385578-R1021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice