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NPI Code Detail

MEDICARE: DR. JENNIFER ELISABETH LOHSE DMD, MS

MEDICARE:  DR. JENNIFER ELISABETH LOHSE  DMD, MS
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
11223P0300XPeriodonticsP0567SC

General Provider Information

NPI Number : 1861496325
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER ELISABETH LOHSE DMD, MS
Provider Business Mailing Address
First Line : 904 COLEMAN BLVD
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29464-4046
Country : US
Telephone Number : 843-971-1609
Fax Number : 843-971-1686
Provider Business Practice Location Address
First Line : 904 COLEMAN BLVD
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29464-4046
Country : US
Telephone Number : 843-971-1609
Fax Number : 843-971-1686
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2005
Last Update Date : 07/08/2007

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Directions to “ DR. JENNIFER ELISABETH LOHSE DMD, MS” Practice Location

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