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General NPI Number Information
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NPI Number | 1033072145
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Entity Type | Organization
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Legal Business Name | LIFEHOUSE DENTAL AND WELLNESS
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 3137 HIGHWAY 9
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City | CHERAW
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State | SC
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Zip | 29520-6633
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Country | US
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Telephone | 843-253-5322
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Fax | 843-253-5214
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Provider Business Mailing Address
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Address Line | PO BOX 1000
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City | CHERAW
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State | SC
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Zip | 29520-1000
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Country | US
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Telephone | 853-253-5322
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Fax | 843-253-5214
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | CHARU CLIFFORD
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Credential | DDS
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Telephone | 843-253-5322
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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 |
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License Number State |
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