Individual
DR. JACK MAXWELL CHINN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
20 E DUNLOUP, SHAWNEE, OK 74804-3201
(405) 275-3510
(405) 275-9111
Mailing address
20 DUNLOUP, SHAWNEE, OK 74804
(405) 275-3510
(405) 275-9111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3701
OK
Other
Enumeration date
10/17/2006
Last updated
05/05/2015
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