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General NPI Number Information
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NPI Number | 1194517631
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Entity Type | Organization
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Legal Business Name | CYPRESS FAMILY DENTAL
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 1807 CROWNE COMMONS WAY STE F7
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City | JOHNS ISLAND
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State | SC
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Zip | 29455-4931
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Country | US
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Telephone | 843-800-1411
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Fax |
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Provider Business Mailing Address
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Address Line | 939 PORTABELLA LN
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City | CHARLESTON
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State | SC
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Zip | 29412-8412
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Country | US
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Telephone | 240-434-8993
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM MICHAEL WALKER
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Credential | DDS
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Telephone | 240-434-8993
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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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