Healthcare Provider Details

I. General information

NPI: 1023753878
Provider Name (Legal Business Name): JOHN DURANT DMD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2022
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7455 CROSS COUNTY RD STE 4
NORTH CHARLESTON SC
29418-8470
US

IV. Provider business mailing address

809 LACHICOTTE CREEK DR
CHARLESTON SC
29492-6505
US

V. Phone/Fax

Practice location:
  • Phone: 843-552-4771
  • Fax:
Mailing address:
  • Phone: 803-225-0145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN A DURANT
Title or Position: OWNER
Credential: DMD
Phone: 803-225-0145