Provider Demographics
NPI:1124246186
Name:CHARLES E. CAUBLE, D.M.D., P.A.
Entity type:Organization
Organization Name:CHARLES E. CAUBLE, D.M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:CAUBLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:864-297-6453
Mailing Address - Street 1:611 HAYWOOD RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-2744
Mailing Address - Country:US
Mailing Address - Phone:864-297-6453
Mailing Address - Fax:864-987-0591
Practice Address - Street 1:611 HAYWOOD RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2744
Practice Address - Country:US
Practice Address - Phone:864-297-6453
Practice Address - Fax:864-987-0591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2911223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty