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General NPI Number Information
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NPI Number | 1962923961
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Entity Type | Individual
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Provider Name | JON HARRISON JOSEY DMD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 06/29/2017
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Provider Practice Location Address
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Address Line | 5576 CAROLINA HWY
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City | DENMARK
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State | SC
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Zip | 29042-2238
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Country | US
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Telephone | 803-793-3365
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Fax |
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Provider Business Mailing Address
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Address Line | 9 HALSEY ST
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City | CHARLESTON
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State | SC
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Zip | 29401-1144
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Country | US
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Telephone | 843-621-0789
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 8936
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License Number State | SC
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