Healthcare Provider Details

I. General information

NPI: 1043280308
Provider Name (Legal Business Name): STEVE CROSSLAND D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 BOWMAN RD SUITE A
MOUNT PLEASANT SC
29464-3237
US

IV. Provider business mailing address

929 BOWMAN RD SUITE A
MOUNT PLEASANT SC
29464-3237
US

V. Phone/Fax

Practice location:
  • Phone: 843-849-9616
  • Fax: 843-971-5219
Mailing address:
  • Phone: 843-849-9616
  • Fax: 843-971-5219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2703
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: