Provider Demographics
NPI:1912046814
Name:KNAPP, CHARLES IRA (DDS, MA, MS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:IRA
Last Name:KNAPP
Suffix:
Gender:M
Credentials:DDS, MA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8008 MEADOWVIEW DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-2932
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:174 THOMAS JOHNSON DR
Practice Address - Street 2:101
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4423
Practice Address - Country:US
Practice Address - Phone:301-620-1692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD105681223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics