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General NPI Number Information
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NPI Number | 1184346983
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Entity Type | Individual
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Provider Name | AUSTIN PERDUE D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 701 WILSON ST
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City | CHESTER
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State | SC
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Zip | 29706-8568
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Country | US
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Telephone | 803-581-3555
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Fax |
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Provider Business Mailing Address
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Address Line | 627 AMBERJACK PL
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City | YORK
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State | SC
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Zip | 29745-7794
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Country | US
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Telephone | 864-790-1814
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DGD.10506
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License Number State | SC
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