Provider Demographics
NPI:1124140934
Name:MESSA, CHARLES ANGELO JR (DDS MAGD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ANGELO
Last Name:MESSA
Suffix:JR
Gender:M
Credentials:DDS MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 W LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-2825
Mailing Address - Country:US
Mailing Address - Phone:610-269-7000
Mailing Address - Fax:610-873-7269
Practice Address - Street 1:72 W LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2825
Practice Address - Country:US
Practice Address - Phone:610-269-7000
Practice Address - Fax:610-873-7269
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0156732122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist