MEDICARE: LOWCOUNTRY CENTER FOR PROSTHODONTIC CARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	3764	SC
2	1223P0700X	Prosthodontics	0585	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043301146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOWCOUNTRY CENTER FOR PROSTHODONTIC CARE

Provider Business Mailing Address
First Line	:	25 CLARK SUMMIT DR
Second Line	:
City	:	BLUFFTON
State	:	SC
Zip	:	29910-4205
Country	:	US
Telephone Number	:	843-706-3800
Fax Number	:	843-706-3802

Provider Business Practice Location Address
First Line	:	25 CLARK SUMMIT DR
Second Line	:
City	:	BLUFFTON
State	:	SC
Zip	:	29910-4205
Country	:	US
Telephone Number	:	843-706-3800
Fax Number	:	843-706-3802

Authorized Official
Title or Position	:	DENTIST
Name	:	VIRGIL VACAREAN
Credential	:	DMD
Telephone Number	:	843-706-3800

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	09/11/2025

Similar Medicare Providers

1891987400 — MRS. JILL ELLEN LAUGHLIN C-PMHNP
Practice Location Address:

25 CLARK SUMMIT DR # F201
BLUFFTON, SC
29910-4205

Practice Phone: 843-757-4737
Practice Fax: 843-757-4585

1235154667 — RICHARD CHADWICK FORD M.D.
Practice Location Address:

25 CLARK SUMMIT DR , SUITE F201
BLUFFTON, SC
29910-4205

Practice Phone: 843-757-4737
Practice Fax: 843-757-4585

1235263252 — DR. JOSEPH WINDHAM WALTERS III MD
Practice Location Address:

25 CLARK SUMMIT DR STE F201 , LOWCOUNTRY PSYCHIATRIC ASSOCIATES
BLUFFTON, SC
29910-4205

Practice Phone: 843-757-4737
Practice Fax: 843-757-4585

1154530848 — CAROLINA CHIROPRACTIC & HOLISTIC CENTER
Practice Location Address:

25 CLARK SUMMIT DR , STE 103
BLUFFTON, SC
29910-4205

Practice Phone: 843-706-2847
Practice Fax: 843-706-3743

1538341888 — DR. CHARLES JASON PUTNAM DMD
Practice Location Address:

25 CLARK SUMMIT DR , SUITE 202 BOX 9
BLUFFTON, SC
29910-4205

Practice Phone: 843-837-8585
Practice Fax: 843-837-8587

1881852515 — VICTORIA ANN BONNELL LISW-CP
Practice Location Address:

25 CLARK SUMMIT DR , F201
BLUFFTON, SC
29910-4205

Practice Phone: 843-757-4737
Practice Fax: 843-757-4585

Directions to “LOWCOUNTRY CENTER FOR PROSTHODONTIC CARE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.