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General NPI Number Information
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NPI Number | 1578956991
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Entity Type | Individual
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Provider Name | CHRISTINA GRACE QUARTERMAN DDS
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Gender | Female
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Dates
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Enumeration Date | 03/10/2015
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 9787 CHARLOTTE HWY STE 203
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City | INDIAN LAND
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State | SC
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Zip | 29707-5511
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Country | US
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Telephone | 803-897-6453
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Fax |
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Provider Business Mailing Address
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Address Line | 9787 CHARLOTTE HWY STE 203
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City | INDIAN LAND
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State | SC
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Zip | 29707-5511
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Country | US
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Telephone | 803-897-6453
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 10498
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 9037
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License Number State | SC
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