| Christy M Fogle Dmd | |
|
776 Daniel Ellis Drive Suite 3a Charleston SC 29412 | |
| (843) 762-2065 | |
| (843) 762-7735 |
| Full Name | Christy M Fogle Dmd |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 776 Daniel Ellis Drive, Charleston, South Carolina |
| Authorized Official Name and Position | Teresa E Wilson (OFFICE MANAGER) |
| Authorized Official Contact | 8437622065 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Christy M Fogle Dmd Po Bx 12290 Charleston SC 29422-2290 Ph: (843) 762-2065 | Christy M Fogle Dmd 776 Daniel Ellis Drive Suite 3a Charleston SC 29412 Ph: (843) 762-2065 |
| NPI Number | 1023180528 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023180528 | NPI | - | NPPES |
| ZA9837 | Medicaid | SC | |
| Z9A9837 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2406 (South Carolina) | Primary |
| 261QD0000X | Clinic/center - Dental | 2406 (South Carolina) | Primary |
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