Healthcare Provider Details

I. General information

NPI: 1972070829
Provider Name (Legal Business Name): LOUIS C. SIGMUND II DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2018
Last Update Date: 10/27/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

674 BLVD DE FRANCE
BEAUFORT SC
29902
US

IV. Provider business mailing address

674 BLVD DE FRANCE
BEAUFORT SC
29902
US

V. Phone/Fax

Practice location:
  • Phone: 843-228-3500
  • Fax:
Mailing address:
  • Phone: 843-228-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10959097-9921
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number9586
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: