Provider Demographics
NPI:1407096639
Name:LANGFORD, CHARLES WILLIAM JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:WILLIAM
Last Name:LANGFORD
Suffix:JR
Gender:M
Credentials:DDS
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Mailing Address - Street 1:445 STABLEFORD CIR
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-7771
Mailing Address - Country:US
Mailing Address - Phone:270-685-0786
Mailing Address - Fax:270-683-2298
Practice Address - Street 1:445 STABLEFORD CIR
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-7771
Practice Address - Country:US
Practice Address - Phone:270-685-0786
Practice Address - Fax:270-683-2298
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-27
Last Update Date:2009-02-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY35131223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery