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General NPI Number Information
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NPI Number | 1558260265
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Entity Type | Organization
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Legal Business Name | THE STANDARD DENTAL CO LLC
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 2060 CHARLIE HALL BLVD STE 5A
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City | CHARLESTON
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State | SC
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Zip | 29414-6091
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Country | US
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Telephone | 520-488-8612
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Fax |
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Provider Business Mailing Address
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Address Line | 845 TRIPE ST
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City | CHARLESTON
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State | SC
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Zip | 29407-6147
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Country | US
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Telephone | 520-488-8612
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH BLAKENEY SITTON
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Credential | DMD
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Telephone | 520-488-8612
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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