Shanks, Charles Hartwell

Shanks, Charles Hartwell is an sole proprietor health care provider with primary practice located at 1511 E Lamar Alexander Pkwy , Maryville TN 37804-5131. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Shanks, Charles Hartwell can be contacted via phone (865) 977-8048.

Contact Information

Primary practice address
1511 E Lamar Alexander Pkwy Maryville TN 37804-5131
Phone: (865) 977-8048
Fax: (865) 977-0318
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X DS7825 Tennessee
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DS7825 Tennessee

Profile Details

NPI number 1558359695
LBN Legal business name Shanks, Charles Hartwell
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 12th, 2005
Last updated Jun 17th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1558359695 NPPES
Tennessee Other 1223S0112X KENTUCKY MEDICAID TAXONOMY CODE
Tennessee Other 201169265 KENTUCKY MEDICAID TAXONOMY CODE
Tennessee Other DS7825 KENTUCKY MEDICAID TAXONOMY CODE
Tennessee Other 1144507351 KENTUCKY MEDICAID TAXONOMY CODE

Popular Providers