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General NPI Number Information
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NPI Number | 1396652921
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Entity Type | Organization
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Legal Business Name | LOWCOUNTRY ORAL SURGERY
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Dates
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Enumeration Date | 08/27/2026
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Last Update Date | 08/27/2026
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Provider Practice Location Address
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Address Line | 846 SAINT ANDREWS BLVD STE B
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City | CHARLESTON
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State | SC
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Zip | 29407-7148
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Country | US
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Telephone | 865-381-8867
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Fax | 865-419-0888
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Provider Business Mailing Address
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Address Line | 974 HIGHWAY 321 N STE 104
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City | LENOIR CITY
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State | TN
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Zip | 37771-2177
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Country | US
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Telephone | 865-381-8867
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Fax | 865-419-0888
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Authorized Official
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Title or Position | OWNER
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Name | OTTO WILLIAM SLATER
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Credential | DDS
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Telephone | 865-381-8867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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