Provider Demographics
NPI:1528163839
Name:RAWSON, CHARLES W (DMD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:W
Last Name:RAWSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MAINE ST
Mailing Address - Street 2:SUITE 409
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2026
Mailing Address - Country:US
Mailing Address - Phone:207-729-1159
Mailing Address - Fax:207-721-0792
Practice Address - Street 1:14 MAINE ST
Practice Address - Street 2:SUITE 409
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2026
Practice Address - Country:US
Practice Address - Phone:207-729-1159
Practice Address - Fax:207-721-0792
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME26641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice