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125 Wappoo Creek Dr Suite 1 Charleston SC 29412-2163 | |
| (843) 762-9028 | |
| (843) 762-9030 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 125 Wappoo Creek Dr, Charleston, South Carolina |
| Authorized Official Name and Position | Edward R Strauss (OWNER) |
| Authorized Official Contact | 8437629028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
125c Wappoo Creek Dr Suite 1 Charleston SC 29412-2163 Ph: (843) 762-9028 | 125 Wappoo Creek Dr Suite 1 Charleston SC 29412-2163 Ph: (843) 762-9028 |
| NPI Number | 1043409063 |
|---|---|
| Provider Enumeration Date | 10/16/2007 |
| Last Update Date | 10/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043409063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 4006 (South Carolina) | Primary |
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