MEDICARE: DONOVAN FAMILY DENTISTRY, 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
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1851237770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONOVAN FAMILY DENTISTRY, LLC

Provider Business Mailing Address
First Line	:	91 SAMS POINT RD
Second Line	:
City	:	BEAUFORT
State	:	SC
Zip	:	29907-2010
Country	:	US
Telephone Number	:	843-525-6866
Fax Number	:	843-525-6866

Provider Business Practice Location Address
First Line	:	91 SAMS POINT RD
Second Line	:
City	:	BEAUFORT
State	:	SC
Zip	:	29907-2010
Country	:	US
Telephone Number	:	843-525-6866
Fax Number	:	843-525-6866

Authorized Official
Title or Position	:	OWNER
Name	:	WILLIAM COLLINS DONOVAN
Credential	:	DMD
Telephone Number	:	843-525-6866

Provider Enumeration Date	:	04/24/2026
Last Update Date	:	04/24/2026

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