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NPI Code Detail

MEDICARE: JOHN DURANT DMD LLC

MEDICARE: JOHN DURANT DMD LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11902303852OTHERINDIVIDUAL NPI

General Provider Information

NPI Number : 1023753878
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN DURANT DMD LLC
Provider Business Mailing Address
First Line : 809 LACHICOTTE CREEK DR
Second Line :
City : CHARLESTON
State : SC
Zip : 29492-6505
Country : US
Telephone Number : 803-225-0145
Fax Number :
Provider Business Practice Location Address
First Line : 7455 CROSS COUNTY RD STE 4
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29418-8470
Country : US
Telephone Number : 843-552-4771
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. JOHN A DURANT
Credential : DMD
Telephone Number : 803-225-0145
Provider Enumeration Date : 05/04/2022
Last Update Date : 05/04/2022

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Directions to “JOHN DURANT DMD LLC ” Practice Location

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