| Charleston Oral Medicine, Llc | |
| 3700 Ingleside Blvd Ste 101 Ladson SC 29456-4141 | |
| (843) 762-9028 | |
| Not Available | 
| Full Name | Charleston Oral Medicine, Llc | 
|---|---|
| Speciality | Clinic/center - Dental | 
| Location | 3700 Ingleside Blvd Ste 101, Ladson, South Carolina | 
| Authorized Official Name and Position | Lynda Tyler (CONTROLLER) | 
| Authorized Official Contact | 8439745236 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Charleston Oral Medicine, Llc 3700 Ingleside Blvd Ste 101 Ladson SC 29456-4141 Ph: (843) 762-9028 | Charleston Oral Medicine, Llc 3700 Ingleside Blvd Ste 101 Ladson SC 29456-4141 Ph: (843) 762-9028 | 
| NPI Number | 1346925781 | 
|---|---|
| Provider Enumeration Date | 06/21/2023 | 
| Last Update Date | 06/21/2023 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1346925781 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary | 
| Ingleside Family Dental, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9403 Highway 78, Suite 201, Ladson, SC 29456 Phone: 845-702-0581 | |
| Heritage Dental Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9598 Palmetto Commerce Parkway, Ladson, SC 29456 Phone: 860-573-5681 | |
| Crane Family Dentistry Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9565 Highway 78 Bldg 600b, Ladson, SC 29456 Phone: 843-412-4036 | |
| Dr. Patricia Nicklas Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 9565 Highway 78, Unit 600b, Ladson, SC 29456 Phone: 843-412-4036 |