Provider Demographics
NPI:1851452486
Name:CHARLES M. GUIZZOTTI, D.D.S., P.A.
Entity type:Organization
Organization Name:CHARLES M. GUIZZOTTI, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GUIZZOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-947-2411
Mailing Address - Street 1:4824 HIGHWAY 15-501
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NC
Mailing Address - Zip Code:28327
Mailing Address - Country:US
Mailing Address - Phone:910-947-2411
Mailing Address - Fax:910-947-2719
Practice Address - Street 1:4824 HIGHWAY 15-501
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:NC
Practice Address - Zip Code:28327-1299
Practice Address - Country:US
Practice Address - Phone:910-947-2411
Practice Address - Fax:910-947-2719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC81151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty