MEDICARE: CHESTER DENTAL 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	1223G0001X	General Practice Dentistry	2769	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	:	1447255377
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHESTER DENTAL CARE

Provider Business Mailing Address
First Line	:	726 WILSON ST
Second Line	:
City	:	CHESTER
State	:	SC
Zip	:	29706
Country	:	US
Telephone Number	:	803-581-2345
Fax Number	:	803-581-8854

Provider Business Practice Location Address
First Line	:	726 WILSON ST
Second Line	:
City	:	CHESTER
State	:	SC
Zip	:	29706
Country	:	US
Telephone Number	:	803-581-2345
Fax Number	:	803-581-8854

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEPHEN C. ADKINSON
Credential	:	D.M.D.
Telephone Number	:	803-581-2345

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	08/22/2020

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Directions to “CHESTER DENTAL CARE ” Practice Location

Language	Start Address	Practice Location

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