| Dr Charles L Proesel Jr, DDS | |
| 
					205 E Gridley Rd, Gridley, IL 61744-8733  | |
| (309) 747-2213 | |
| (309) 747-3989 | 
| Full Name | Dr Charles L Proesel Jr | 
|---|---|
| Gender | Male | 
| Speciality | Dentist - Dental Public Health | 
| Location | 205 E Gridley Rd, Gridley, Illinois | 
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1972508364 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223D0001X | Dentist - Dental Public Health | 19A14491 (Illinois) | Primary | 
| Mailing Address | Practice Location Address | 
|---|---|
| Dr Charles L Proesel Jr, DDS Po Box 288, Gridley, IL 61744-0288 Ph: (309) 747-2213  | Dr Charles L Proesel Jr, DDS 205 E Gridley Rd, Gridley, IL 61744-8733 Ph: (309) 747-2213  | 
Dr. Timothy D. Supan, D.M.D. Dentist Medicare: Medicare Enrolled Practice Location: 205 E Gridley Rd, Gridley, IL 61744 Phone: 309-747-2213 Fax: 309-747-3989  | |
Dr. Nicole Eileen Elger, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 205 E Gridley Rd, Gridley, IL 61744 Phone: 309-747-2213  | |
Dr. Stephen T. Blue, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 205 E Gridley Rd, Gridley, IL 61744 Phone: 309-747-2213 Fax: 309-747-3989  |