Provider Demographics
NPI:1811058563
Name:GUIZZOTTI, CHARLES MICHAEL (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:MICHAEL
Last Name:GUIZZOTTI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2107 CRIGAN BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8352
Mailing Address - Country:US
Mailing Address - Phone:919-234-3554
Mailing Address - Fax:919-234-3554
Practice Address - Street 1:4824 HIGHWAY 15-501
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:NC
Practice Address - Zip Code:28327-1299
Practice Address - Country:US
Practice Address - Phone:910-947-2411
Practice Address - Fax:910-947-2719
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC81151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice