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General NPI Number Information
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NPI Number | 1710178793
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Entity Type | Organization
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Legal Business Name | DDS SERVICES, LLC
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 08/06/2007
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Provider Practice Location Address
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Address Line | 110 MEDICAL LN E SUITE 115
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-4817
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Country | US
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Telephone | 803-739-4805
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Fax | 803-739-4810
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Provider Business Mailing Address
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Address Line | 110 MEDICAL LN E SUITE 115
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-4817
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Country | US
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Telephone | 803-739-4805
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Fax | 803-739-4810
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Authorized Official
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Title or Position | CEO
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Name | DR. JAMES E. MERCER
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Credential | DDS
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Telephone | 803-739-4805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 2941
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License Number State | SC
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