Provider Demographics
NPI:1881687887
Name:SHINKLE, HARLAN K (DDS)
Entity Type:Individual
Prefix:
First Name:HARLAN
Middle Name:K
Last Name:SHINKLE
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 1:1113 CHAMPA ST
Mailing Address - Street 2:
Mailing Address - City:PRATT
Mailing Address - State:KS
Mailing Address - Zip Code:67124-1205
Mailing Address - Country:US
Mailing Address - Phone:620-672-2078
Mailing Address - Fax:620-672-3624
Practice Address - Street 1:610 E 2ND ST
Practice Address - Street 2:
Practice Address - City:PRATT
Practice Address - State:KS
Practice Address - Zip Code:67124-2912
Practice Address - Country:US
Practice Address - Phone:620-672-5536
Practice Address - Fax:620-672-3624
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS57931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice