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General NPI Number Information
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NPI Number | 1104743590
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Entity Type | Organization
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Legal Business Name | DORCHESTER ORTHO LLC
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 8626 DORCHESTER RD STE 102
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City | NORTH CHARLESTON
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State | SC
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Zip | 29420-7328
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Country | US
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Telephone | 843-261-2001
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Fax | 843-738-6942
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Provider Business Mailing Address
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Address Line | 8626 DORCHESTER RD STE 102
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City | NORTH CHARLESTON
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State | SC
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Zip | 29420-7328
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Country | US
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Telephone | 843-261-2001
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Fax | 843-738-6942
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Authorized Official
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Title or Position | CREDENTIALING AND ENROLLMENT
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Name | JENNI TOMLINSON
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Credential |
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Telephone | 470-552-1823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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