Provider Demographics
NPI:1669568036
Name:NOTTINGHAM, CHARLES ERNEST (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ERNEST
Last Name:NOTTINGHAM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4048 WEST HILLSBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442
Mailing Address - Country:US
Mailing Address - Phone:954-429-8506
Mailing Address - Fax:954-429-9480
Practice Address - Street 1:4048 WEST HILLSBORO BLVD
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442
Practice Address - Country:US
Practice Address - Phone:954-429-8506
Practice Address - Fax:954-429-9480
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL60911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice