| Community Dental Center | |
|
51 Nassau St Charleston SC 29403-5513 | |
| (843) 722-4112 | |
| (843) 557-9550 |
| Full Name | Community Dental Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 51 Nassau St, Charleston, South Carolina |
| Authorized Official Name and Position | Aretha R Jones (CEO) |
| Authorized Official Contact | 8437224112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Dental Center 51 Nassau St Charleston SC 29403-5513 Ph: (843) 722-4112 | Community Dental Center 51 Nassau St Charleston SC 29403-5513 Ph: (843) 722-4112 |
| NPI Number | 1245639095 |
|---|---|
| Provider Enumeration Date | 08/18/2014 |
| Last Update Date | 10/28/2022 |
| Medicare PECOS PAC ID | 9032215199 |
|---|---|
| Medicare Enrollment ID | O20151120000684 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245639095 | NPI | - | NPPES |
| ZA8983 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Secondary |
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