Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 008826 | CT |
NPI | 1548236045 |
---|---|
Provider Name | Dr. Charles C Truncale |
First Address | Washington, DC 20593-0001 |
Second Address | New London, CT 06030-3906 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2006 |
Last Update Date | 08/07/2007 |