Provider Demographics
NPI:1528124385
Name:CALDER, CHARLES T (DDS MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:T
Last Name:CALDER
Suffix:
Gender:M
Credentials:DDS MD
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Mailing Address - Street 1:9745 W DIABLO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148
Mailing Address - Country:US
Mailing Address - Phone:702-740-4372
Mailing Address - Fax:702-798-5589
Practice Address - Street 1:6140 SOUTH FORT APACHE ROAD
Practice Address - Street 2:STE 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148
Practice Address - Country:US
Practice Address - Phone:702-655-8400
Practice Address - Fax:702-255-8409
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA472361223S0112X
NVS2-531223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery