Provider Demographics
NPI:1639388390
Name:PAYET, CHARLES D (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:D
Last Name:PAYET
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 1:4601 PARK RD STE 175
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-2297
Mailing Address - Country:US
Mailing Address - Phone:704-364-7069
Mailing Address - Fax:704-364-7036
Practice Address - Street 1:4601 PARK RD STE 175
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28209-2297
Practice Address - Country:US
Practice Address - Phone:704-364-7069
Practice Address - Fax:704-364-7036
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC68561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice