DR. Charles J Tannenbaum, DDS

NPI #1720252224 in Mchenry, Illinois

Provider Information

NPI Number: 1720252224
Entity Type: Individual
Name: DR. Charles J Tannenbaum, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Apr 15, 2008
Last Updated: Jan 1, 2012

Practice Location

Address: 5404 W ELM ST
Address 2: STE F
City: Mchenry
State: Illinois
ZIP Code: 60050-4052
Phone: (815) 759-0871

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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