DR. Charles Richard Holmen, DMD

NPI #1780702068 in Waterloo, Illinois

Provider Information

NPI Number: 1780702068
Entity Type: Individual
Name: DR. Charles Richard Holmen, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DMD
Enumeration Date: Mar 26, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 208 BRADFORD LANE
City: Waterloo
State: Illinois
ZIP Code: 62298
Phone: (618) 939-7181

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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