Individual provider · Type 1 NPI

Charles E. Conklin Jr., DDS

Oral and Maxillofacial Surgery (Dentist) · Roanoke, VA

NPI number 1366410839 Active

Practice location

2017 Jefferson St SW, Carilion Dental Clinic
Roanoke, VA 24014-2419

Call (540) 981-7128 Map

Mailing address

4569 Keagy Rd
Roanoke, VA 24018-7417

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X0401-004990 (VA)

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

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About NPI 1366410839

Charles E. Conklin Jr., DDS's National Provider Identifier is 1366410839, issued on Mar 10, 2006. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Roanoke, VA. The record was last updated on Apr 30, 2008.