Provider Demographics
NPI:1265557508
Name:DUCHSCHER, CHARLES LOUIS JR (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:LOUIS
Last Name:DUCHSCHER
Suffix:JR
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 1:803 COFFEE RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-4227
Mailing Address - Country:US
Mailing Address - Phone:209-521-5486
Mailing Address - Fax:
Practice Address - Street 1:803 COFFEE RD
Practice Address - Street 2:SUITE 8
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-4227
Practice Address - Country:US
Practice Address - Phone:209-521-5486
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23599122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist