| 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 |
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