| Fetter Mobile Dental Vehicle | |
|
51 Nassau St Charleston SC 29403 | |
| (843) 722-4112 | |
| Not Available |
| Full Name | Fetter Mobile Dental Vehicle |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 51 Nassau St, Charleston, South Carolina |
| Authorized Official Name and Position | Aretha R Jones (CEO) |
| Authorized Official Contact | 8437224112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fetter Mobile Dental Vehicle 51 Nassau St Charleston SC 29403-5513 Ph: (843) 722-4112 | Fetter Mobile Dental Vehicle 51 Nassau St Charleston SC 29403 Ph: (843) 722-4112 |
| NPI Number | 1194211243 |
|---|---|
| Provider Enumeration Date | 07/02/2018 |
| Last Update Date | 10/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194211243 | NPI | - | NPPES |
| ZA8983 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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