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General NPI Number Information
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NPI Number | 1407113848
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Entity Type | Organization
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Legal Business Name | NORTH CHARLESTON DENTAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 8310 RIVERS AVE
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-9268
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Country | US
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Telephone | 843-797-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 8310 RIVERS AVE
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-9268
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Country | US
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Telephone | 843-797-7200
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. JOHN F. DUNBAR JR.
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Credential | DMD
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Telephone | 864-573-9255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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