Healthcare Provider Details

I. General information

NPI: 1477867281
Provider Name (Legal Business Name): R JASON J HEHR, DMD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2010
Last Update Date: 08/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 NETHERBY RD SUITE 1200
NORTH CHARLESTON SC
29420-7363
US

IV. Provider business mailing address

5401 NETHERBY RD SUITE 1200
NORTH CHARLESTON SC
29420-7363
US

V. Phone/Fax

Practice location:
  • Phone: 843-767-3310
  • Fax: 843-767-3455
Mailing address:
  • Phone: 843-767-3310
  • Fax: 843-767-3455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0112X
TaxonomyOral and Maxillofacial Surgery Clinic/Center
License Number4030 698OS
License Number StateSC

VIII. Authorized Official

Name: DR. R JASON J HEHR I
Title or Position: PRACTITIONER/OWNER
Credential: DMD
Phone: 843-767-3310