Provider Demographics
NPI:1477516284
Name:PALIAN, CHARLES W (DMD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:W
Last Name:PALIAN
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 1:405 CENTER ST
Mailing Address - Street 2:CENTRAL MAINE ORAL SURGERY
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-6135
Mailing Address - Country:US
Mailing Address - Phone:207-783-4705
Mailing Address - Fax:207-753-0659
Practice Address - Street 1:405 CENTER ST
Practice Address - Street 2:CENTRAL MAINE ORAL SURGERY
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-6135
Practice Address - Country:US
Practice Address - Phone:207-783-4705
Practice Address - Fax:207-753-0659
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS2-33C1223S0112X
ME27911223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery