| J D Rucker Jr Dds Pa | |
|
145 Center Street Chester SC 29704-2704 | |
| (803) 377-1157 | |
| (803) 385-6898 |
| Full Name | J D Rucker Jr Dds Pa |
|---|---|
| Speciality | Dentist |
| Location | 145 Center Street, Chester, South Carolina |
| Authorized Official Name and Position | James D Rucker (OWNER PRESIDENT) |
| Authorized Official Contact | 8033771157 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| J D Rucker Jr Dds Pa Po Box 147 Chester SC 29704-2704 Ph: (803) 377-1157 | J D Rucker Jr Dds Pa 145 Center Street Chester SC 29704-2704 Ph: (803) 377-1157 |
| NPI Number | 1437284072 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437284072 | NPI | - | NPPES |
| ZA9826 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | Z1899 (South Carolina) | Primary |
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