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159 Wentworth St Charleston SC 29401-1731 | |
| (843) 577-2898 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 159 Wentworth St, Charleston, South Carolina |
| Authorized Official Name and Position | Margaret Mckenzie Raymond Woodard (MANAGER) |
| Authorized Official Contact | 8043877108 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
500 Bucksley Ln Unit 207 Daniel Island SC 29492-8182 Ph: (804) 387-7108 | 159 Wentworth St Charleston SC 29401-1731 Ph: (843) 577-2898 |
| NPI Number | 1386074490 |
|---|---|
| Provider Enumeration Date | 11/26/2013 |
| Last Update Date | 11/26/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386074490 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8200 (South Carolina) | Primary |
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