Charles Arthur Short, DDS
Individual provider Active NPI General Practice Dentistry · Groves, TX
NPI 1992097752 · NPPES record last updated May 11, 2011
Key facts
- NPI
- 1992097752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12761 (TX)
- Practice address
- 5406 39TH St
Groves, TX 77619-2914 - Phone
- (409) 962-3733
- Fax
- (409) 962-5757
- NPI assigned
- May 11, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12761 | TX | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12761 | TX | Yes |
Addresses
Primary practice location
5406 39TH St
Groves, TX 77619-2914
Mailing address
5406 39TH St
Groves, TX 77619-2914
Phone (409) 962-3733
Other providers in Groves, TX
- Brittany Segura
- Selman Group
- Selman Partners LLC
- Thomas William Selman Jr.
- William Chase Selman
- Jonathan Smith
- Sarah Smith
- Alexis Speer
- Star Mental Health Services, P.C.
- Heather Stippel
All providers in Groves, TX · General Practice Dentistry in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.