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General NPI Number Information
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NPI Number | 1427673946
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Entity Type | Individual
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Provider Name | LESLIE JORDAN MCGARITY
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Gender | Female
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Dates
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Enumeration Date | 06/10/2020
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Last Update Date | 06/10/2020
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Provider Practice Location Address
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Address Line | 29 BEE STREET DC 271 MSC 507
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City | CHARLESTON
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State | SC
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Zip | 29425-0001
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Country | US
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Telephone | 843-792-8140
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Fax |
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Provider Business Mailing Address
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Address Line | 74 BULL ST
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City | CHARLESTON
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State | SC
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Zip | 29401-1303
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Country | US
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Telephone | 803-530-3691
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DGD.9655
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License Number State | SC
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