Provider Demographics
NPI:1497829733
Name:DORR, CHARLES H JR (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:H
Last Name:DORR
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:PO BOX 528
Mailing Address - Street 2:
Mailing Address - City:MACHIAS
Mailing Address - State:ME
Mailing Address - Zip Code:04654
Mailing Address - Country:US
Mailing Address - Phone:207-255-3352
Mailing Address - Fax:207-255-8832
Practice Address - Street 1:25 HADLEY LAKE ROAD
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:ME
Practice Address - Zip Code:04654
Practice Address - Country:US
Practice Address - Phone:207-255-3352
Practice Address - Fax:207-255-8832
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2420122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist