Individual provider · Type 1 NPI

Charles Vansicklen, DDS

Student in an Organized Health Care Education/Training Program · Stockton, CA

NPI number 1629489315 Active

Practice location

8619 Emanuel Way
Stockton, CA 95212-1423

Call (209) 931-7931 Map

Mailing address

1430 John Wesley Gilbert Dr
Augusta, GA 30912-0001

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1629489315

Charles Vansicklen, DDS's National Provider Identifier is 1629489315, issued on May 15, 2014. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Stockton, CA. The record was last updated on May 15, 2014.