| Archdale Family Dentistry | |
|
5306 Parkshire Way North Charleston SC 29418-2000 | |
| (843) 552-1600 | |
| (843) 552-0049 |
| Full Name | Archdale Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 5306 Parkshire Way, North Charleston, South Carolina |
| Authorized Official Name and Position | Jack M. Condrey (DENTIST) |
| Authorized Official Contact | 8435521600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Archdale Family Dentistry 5306 Parkshire Way North Charleston SC 29418-2000 Ph: (843) 552-1600 | Archdale Family Dentistry 5306 Parkshire Way North Charleston SC 29418-2000 Ph: (843) 552-1600 |
| NPI Number | 1245574995 |
|---|---|
| Provider Enumeration Date | 11/19/2012 |
| Last Update Date | 11/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245574995 | NPI | - | NPPES |
| ZX2785 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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