Provider Demographics
NPI:1649280322
Name:FRENCH II, CHARLES RAY (DMD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:RAY
Last Name:FRENCH II
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5282 POND MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:BROAD RUN
Mailing Address - State:VA
Mailing Address - Zip Code:20137-2027
Mailing Address - Country:US
Mailing Address - Phone:540-351-0558
Mailing Address - Fax:
Practice Address - Street 1:46161 WESTLAKE DR
Practice Address - Street 2:#220
Practice Address - City:POTOMAC FALLS
Practice Address - State:VA
Practice Address - Zip Code:20165-5871
Practice Address - Country:US
Practice Address - Phone:703-430-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010060351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice