MEDICARE: JAMES DAVID HART DMD

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	3527	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881618247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES DAVID HART DMD

Provider Business Mailing Address
First Line	:	1204 PALM BLVD
Second Line	:	SUITE A
City	:	ISLE OF PALMS
State	:	SC
Zip	:	29451-2297
Country	:	US
Telephone Number	:	843-886-3836
Fax Number	:	843-886-5514

Provider Business Practice Location Address
First Line	:	1204 PALM BLVD
Second Line	:	SUITE A
City	:	ISLE OF PALMS
State	:	SC
Zip	:	29451-2297
Country	:	US
Telephone Number	:	843-886-3836
Fax Number	:	843-886-5514

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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Directions to “ JAMES DAVID HART DMD” Practice Location

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