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General NPI Number Information
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NPI Number | 1013123983
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Entity Type | Organization
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Legal Business Name | ELIZABETH J. BJORNSON, DDS, MHS, PA
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1321 CHUCK DAWLEY BLVD SUITE 101
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City | MT PLEASANT
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State | SC
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Zip | 29464-7304
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Country | US
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Telephone | 843-881-9909
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Fax | 843-881-8481
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Provider Business Mailing Address
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Address Line | 1321 CHUCK DAWLEY BLVD SUITE 101
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City | MT PLEASANT
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State | SC
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Zip | 29464-7304
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Country | US
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Telephone | 843-881-9909
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Fax | 843-881-8481
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Authorized Official
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Title or Position | OFFICER
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Name | DR. ELIZABETH JANE BJORNSON
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Credential | DDS, MHS
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Telephone | 843-881-9909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 0352
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License Number State | SC
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