Provider Demographics
NPI:1346492089
Name:TREBILCOCK, CHARLES E (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:E
Last Name:TREBILCOCK
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 BERRY LEAF LN
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-3140
Mailing Address - Country:US
Mailing Address - Phone:614-771-5960
Mailing Address - Fax:
Practice Address - Street 1:3905 BERRY LEAF LN
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-3140
Practice Address - Country:US
Practice Address - Phone:614-771-5960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH202691223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics