Healthcare Provider Details

I. General information

NPI: 1952798357
Provider Name (Legal Business Name): NOW OR NEVER 2011, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2015
Last Update Date: 04/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2270 ASHLEY CROSSING DR STE 175
CHARLESTON SC
29414-5863
US

IV. Provider business mailing address

2270 ASHLEY CROSSING DR STE 175
CHARLESTON SC
29414-5863
US

V. Phone/Fax

Practice location:
  • Phone: 843-410-5766
  • Fax: 843-410-5767
Mailing address:
  • Phone: 843-410-5766
  • Fax: 843-410-5767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number3868
License Number StateSC

VIII. Authorized Official

Name: DR. FREDERICK M DILLARD
Title or Position: OWNER
Credential: DMD, MS
Phone: 843-410-5766