Healthcare Provider Details

I. General information

NPI: 1801689211
Provider Name (Legal Business Name): PETER D MAULDIN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2680 ELMS PLANTATION BLVD STE 103
NORTH CHARLESTON SC
29406-7101
US

IV. Provider business mailing address

400 MEMORIAL DRIVE EXT STE 400
GREER SC
29651-1850
US

V. Phone/Fax

Practice location:
  • Phone: 843-797-6919
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDGD.11101GD
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: