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General NPI Number Information
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NPI Number | 1922499011
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Entity Type | Organization
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Legal Business Name | CHAPIN ORAL AND MAXILLOFACIAL SURGERY, LLC
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Dates
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Enumeration Date | 02/10/2015
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Last Update Date | 02/10/2015
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Provider Practice Location Address
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Address Line | 112 ST. PETER'S CHURCH ROAD
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City | CHAPIN
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State | SC
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Zip | 29036
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Country | US
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Telephone | 803-816-2795
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Fax |
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Provider Business Mailing Address
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Address Line | 112 ST. PETER'S CHURCH RD
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City | CHAPIN
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State | SC
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Zip | 29036
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Country | US
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Telephone | 803-816-2795
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | ADAM D. HAIRR
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Credential | DDS
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Telephone | 803-816-2795
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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 | 7138
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License Number State | SC
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