Provider Demographics
NPI:1134266158
Name:LINDSEY, CHARLES A (DMD,MSD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:A
Last Name:LINDSEY
Suffix:
Gender:M
Credentials:DMD,MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 WEST COLLEGE STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-4238
Mailing Address - Country:US
Mailing Address - Phone:770-228-1223
Mailing Address - Fax:770-228-8577
Practice Address - Street 1:120 W. COLLEGE ST.
Practice Address - Street 2:STE. A
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4238
Practice Address - Country:US
Practice Address - Phone:770-228-1223
Practice Address - Fax:770-228-8577
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0100411223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics