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General NPI Number Information
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NPI Number | 1194964676
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Entity Type | Organization
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Legal Business Name | DENTAL HEALTH SERVICES
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Dates
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Enumeration Date | 02/06/2009
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Last Update Date | 02/06/2009
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Provider Practice Location Address
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Address Line | 531 FOLLY RD
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City | CHARLESTON
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State | SC
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Zip | 29412
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Country | US
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Telephone | 843-795-1111
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Fax | 843-795-8275
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Provider Business Mailing Address
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Address Line | 531 FOLLY RD
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City | CHARLESTON
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State | SC
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Zip | 29412
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Country | US
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Telephone | 843-795-1111
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Fax | 843-795-8275
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT J. BEALL
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Credential | D.M.D.
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Telephone | 843-795-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 3448
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License Number State | SC
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