Provider Demographics
NPI:1891843207
Name:APPLEBAUM, CHARLES JOEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:JOEL
Last Name:APPLEBAUM
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 1:841 STRATFIELD RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-1651
Mailing Address - Country:US
Mailing Address - Phone:203-333-3381
Mailing Address - Fax:203-333-4487
Practice Address - Street 1:841 STRATFIELD RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-1651
Practice Address - Country:US
Practice Address - Phone:203-333-3381
Practice Address - Fax:203-333-4487
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4292122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist