Organization
CHARLES H. SHANKS, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES HARTWELL SHANKS ORAL SURGEON (OWNER)
(865) 977-8048
Entity
Organization
Contact information
Practice address
1511 E LAMAR ALEXANDER PKWY, MARYVILLE, TN 37804-5131
(865) 977-8048
(865) 977-0318
Mailing address
1511 E LAMAR ALEXANDER PKWY, MARYVILLE, TN 37804-5131
(865) 977-8048
(865) 977-0318
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
DS7825
TN
Other
Enumeration date
11/16/2011
Last updated
02/10/2012
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