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Contact Information

CHARLES K FUQUA, DDS
2444 S DETROIT AVE
C KEITH FUGUA DDS
MAUMEE, OH43537
 Phone: 419-893-8431
 Fax: 419-893-7234
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for CHARLES K FUQUA · (Male)

NPI # 1003980103
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 11/20/2006
Last updated 12/11/2012 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • OH License # 14255
  • OH Medicaid 0227150
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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