Individual provider · NPI-1

Dr. Jack Maxwell Chinn, D.D.S.

Dentist · Shawnee, OK

NPI number1982785192
StatusActive
Last updated in NPPESMay 5, 2015

Details

NPI
1982785192
Entity type
Individual (NPI-1)
Name
Dr. Jack Maxwell Chinn
Credential
D.D.S.
Sex
Male
Sole proprietor
Yes
Enumeration date
Oct 17, 2006
Last updated
May 5, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist3701OKYes

Practice location

20 E Dunloup
Shawnee, OK 74804-3201

Phone 405-275-3510 · Fax 405-275-9111

Mailing address

20 Dunloup
Shawnee, OK 74804

Phone 405-275-3510 · Fax 405-275-9111

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