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General NPI Number Information
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NPI Number | 1235312356
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Entity Type | Organization
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Legal Business Name | CHADWICK & KOLMODIN
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 1818 REMOUNT RD
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City | HANAHAN
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State | SC
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Zip | 29410
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Country | US
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Telephone | 843-744-6971
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Fax | 843-744-3120
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Provider Business Mailing Address
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Address Line | 1818 REMOUNT RD
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City | HANAHAN
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State | SC
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Zip | 29410
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Country | US
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Telephone | 843-744-6971
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Fax | 843-744-3120
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. STEPHEN C CHADWICK
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Credential | DMD
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Telephone | 843-744-6971
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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 | 3436
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 1206
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 963
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 3252
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License Number State | SC
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