Provider Demographics
NPI:1225199102
Name:SCHWEPFINGER, CHARLES BROOK (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:BROOK
Last Name:SCHWEPFINGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 474
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-0474
Mailing Address - Country:US
Mailing Address - Phone:865-882-1945
Mailing Address - Fax:865-882-1987
Practice Address - Street 1:1305 S ROANE ST
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:TN
Practice Address - Zip Code:37748-7537
Practice Address - Country:US
Practice Address - Phone:865-882-1945
Practice Address - Fax:865-882-1987
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000034861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice