Provider Demographics
NPI:1174685960
Name:BOCKS, CHARLES RUDOLPH III (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:RUDOLPH
Last Name:BOCKS
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:1660 WILLOW ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-5101
Mailing Address - Country:US
Mailing Address - Phone:408-266-4571
Mailing Address - Fax:408-267-9016
Practice Address - Street 1:1660 WILLOW ST
Practice Address - Street 2:SUITE 7
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-5101
Practice Address - Country:US
Practice Address - Phone:408-266-4571
Practice Address - Fax:408-267-9016
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA227831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice