Trident General Dentistry, Douglas S Rawls, Dm | |
6335 Dorchester Road North Carleston SC 29418 | |
(843) 552-2580 | |
(843) 552-2596 |
Full Name | Trident General Dentistry, Douglas S Rawls, Dm |
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Speciality | Dentist |
Location | 6335 Dorchester Road, North Carleston, South Carolina |
Authorized Official Name and Position | Douglas S Rawls (OWNER (SINGLE MEMBER OF LLC)) |
Authorized Official Contact | 8435522580 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Trident General Dentistry, Douglas S Rawls, Dm 6335 Dorchester Road North Carleston SC 29418 Ph: (843) 552-2580 | Trident General Dentistry, Douglas S Rawls, Dm 6335 Dorchester Road North Carleston SC 29418 Ph: (843) 552-2580 |
NPI Number | 1437437548 |
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Provider Enumeration Date | 07/25/2011 |
Last Update Date | 07/25/2011 |
Identifier | Type | State | Issuer |
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1437437548 | NPI | - | NPPES |
W17307SC1 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 1823 (South Carolina) | Primary |