Provider Demographics
NPI:1669675500
Name:DOLCE, CHARLES J (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:J
Last Name:DOLCE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8715 W UNION HILLS DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-3029
Mailing Address - Country:US
Mailing Address - Phone:623-584-4882
Mailing Address - Fax:623-512-4179
Practice Address - Street 1:14044 W CAMELBACK RD STE 118
Practice Address - Street 2:
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-9481
Practice Address - Country:US
Practice Address - Phone:623-584-4882
Practice Address - Fax:623-584-6732
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2017-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ41996208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ443801Medicaid
Z91287Medicare PIN