Individual
CHARLES ALBERT HANBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2707 W HUNTSVILLE AVE, SPRINGDALE, AR 72762-7723
(479) 756-8631
Mailing address
2707 W HUNTSVILLE AVE, SPRINGDALE, AR 72762-7723
(479) 756-8631
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2082
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1303179
UNITED CONCORDIA
AR
01
—
2082
DELTA DENTAL
AR
01
—
58250
BCBS
AR
Enumeration date
10/16/2006
Last updated
07/08/2007
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