Healthcare Provider Details

I. General information

NPI: 1982611695
Provider Name (Legal Business Name): JOSEPH LEMBO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 REMOUNT RD
HANAHAN SC
29406
US

IV. Provider business mailing address

1818 REMOUNT RD
HANAHAN SC
29406
US

V. Phone/Fax

Practice location:
  • Phone: 843-744-6971
  • Fax: 846-744-3210
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4163
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: