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General NPI Number Information
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NPI Number | 1811197460
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Entity Type | Individual
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Provider Name | CEDRICK BROWN MCDONALD DDS
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Gender | Male
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 02/11/2023
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Provider Practice Location Address
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Address Line | 9787 CHARLOTTE HWY SUITE 201
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City | INDIAN LAND
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State | SC
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Zip | 29707-8103
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Country | US
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Telephone | 803-547-2280
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Fax |
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Provider Business Mailing Address
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Address Line | 9787 CHARLOTTE HWY SUITE 201
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City | INDIAN LAND
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State | SC
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Zip | 29707-8103
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Country | US
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Telephone | 803-547-2280
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 150632
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN015148
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4382
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License Number State | SC
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