Provider Demographics
NPI:1972277226
Name:CHAMBERS, HANLAN COOKE (DDS)
Entity type:Individual
Prefix:DR
First Name:HANLAN
Middle Name:COOKE
Last Name:CHAMBERS
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 1:3067 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-3415
Mailing Address - Country:US
Mailing Address - Phone:731-668-7916
Mailing Address - Fax:
Practice Address - Street 1:3067 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-3415
Practice Address - Country:US
Practice Address - Phone:731-668-7916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11692122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist