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General NPI Number Information
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NPI Number | 1679883524
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE DENTISTRY FOR ADULTS
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Dates
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Enumeration Date | 10/13/2010
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Last Update Date | 10/13/2010
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Provider Practice Location Address
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Address Line | 7465 NORTHSIDE DR
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City | NORTH CHARLESTON
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State | SC
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Zip | 29420-4209
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Country | US
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Telephone | 843-797-6919
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Fax |
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Provider Business Mailing Address
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Address Line | 7465 NORTHSIDE DR
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City | NORTH CHARLESTON
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State | SC
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Zip | 29420-4209
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Country | US
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Telephone | 843-797-6919
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES C. LESCH
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Credential | DDS
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Telephone | 843-797-6919
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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 | 30-3382
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License Number State | SC
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