| Charleston Periodonticspa | |
|
1051 Gardner Rd Suite A Charleston SC 29407-5747 | |
| (843) 766-7131 | |
| (843) 766-1839 |
| Full Name | Charleston Periodonticspa |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1051 Gardner Rd, Charleston, South Carolina |
| Authorized Official Name and Position | Jeffrey J Laro (PERIODONTIST) |
| Authorized Official Contact | 8437667131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charleston Periodonticspa 1051 Gardner Rd Suite A Charleston SC 29407-5747 Ph: (843) 766-7131 | Charleston Periodonticspa 1051 Gardner Rd Suite A Charleston SC 29407-5747 Ph: (843) 766-7131 |
| NPI Number | 1003955659 |
|---|---|
| Provider Enumeration Date | 02/06/2007 |
| Last Update Date | 05/02/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003955659 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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