Conklin, Charles E

Conklin, Charles E is an individual health care provider with primary practice located at 2017 Jefferson St Sw Carilion Dental Clinic, Roanoke VA 24014-2419. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Conklin, Charles E can be contacted via phone (540) 981-7128.

Contact Information

Primary practice address
2017 Jefferson St Sw Carilion Dental Clinic Roanoke VA 24014-2419
Phone: (540) 981-7128
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 0401-004990 Virginia

Profile Details

NPI number 1366410839
LBN Legal business name Conklin, Charles E
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 10th, 2006
Last updated Apr 30th, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366410839 NPPES
Virginia MEDICAID 7816146
Virginia MEDICAID 7805225

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