Individual
DR. KENNETH L. SHACKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
230 DUNCAN DR, BLDG. 1440 - HAAF, SAVANNAH, GA 31409-5107
(912) 315-5417
Mailing address
25 CHICKADEE RD, HILTON HEAD ISLAND, SC 29926-1806
(843) 681-4142
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2955
SC
Other
Enumeration date
02/27/2006
Last updated
05/13/2015
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