MEDICARE: DR. GREGORY R ORSIMARSI II DMD

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	4629	SC

General Provider Information

NPI Number	:	1932339744
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY R ORSIMARSI II DMD

Provider Business Mailing Address
First Line	:	1677 SAVANNAH HWY
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-6256
Country	:	US
Telephone Number	:	843-556-6575
Fax Number	:	843-556-0207

Provider Business Practice Location Address
First Line	:	1677 SAVANNAH HWY
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29407-6256
Country	:	US
Telephone Number	:	843-556-6575
Fax Number	:	843-556-0207

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2009
Last Update Date	:	11/03/2023

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