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General NPI Number Information
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NPI Number | 1437797495
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Entity Type | Organization
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Legal Business Name | JEFFREY C KOTZ DMD PA
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Dates
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Enumeration Date | 12/20/2019
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 846 SAINT ANDREWS BLVD STE C
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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 | 843-225-9002
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Fax | 843-695-6995
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Provider Business Mailing Address
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Address Line | 846 SAINT ANDREWS BLVD STE C
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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 | 843-225-9002
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Fax | 843-695-6995
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY CLAYTON KOTZ
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Credential | DMD
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Telephone | 843-225-9002
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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 |
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License Number State |
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