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General NPI Number Information
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NPI Number | 1912711888
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Entity Type | Organization
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Legal Business Name | HAMPTON PARK DENTAL
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 700 RUTLEDGE AVE
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City | CHARLESTON
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State | SC
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Zip | 29403-4145
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Country | US
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Telephone | 843-801-9933
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Fax |
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Provider Business Mailing Address
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Address Line | 1850 CREST RD
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City | MARYVILLE
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State | TN
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Zip | 37804-4305
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Country | US
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Telephone | 865-982-1700
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JOSEPH SERRA
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Credential | DDS
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Telephone | 843-801-9933
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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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