Provider Demographics
NPI:1629078035
Name:KESSLER, CHARLES ROYAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ROYAL
Last Name:KESSLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-8757
Mailing Address - Country:US
Mailing Address - Phone:608-783-6384
Mailing Address - Fax:608-781-2111
Practice Address - Street 1:1831 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-8757
Practice Address - Country:US
Practice Address - Phone:608-783-6384
Practice Address - Fax:608-781-2111
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5001780-015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist