Provider Demographics
NPI:1558522508
Name:MACHEMEHL, CHARLES ALBERT III (DMD, MSD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ALBERT
Last Name:MACHEMEHL
Suffix:III
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:9590 MEDLOCK BRIDGE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-4443
Mailing Address - Country:US
Mailing Address - Phone:770-476-9356
Mailing Address - Fax:770-476-7303
Practice Address - Street 1:9590 MEDLOCK BRIDGE RD
Practice Address - Street 2:SUITE A
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-4443
Practice Address - Country:US
Practice Address - Phone:770-476-9356
Practice Address - Fax:770-476-7303
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA98161223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics