| Southeast Endodontics, PC | |
|
10 Farmfield Ave Charleston SC 29407-7756 | |
| (843) 766-0112 | |
| (843) 766-0884 |
| Full Name | Southeast Endodontics, PC |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 10 Farmfield Ave, Charleston, South Carolina |
| Authorized Official Name and Position | Walter R. Long (OWNER) |
| Authorized Official Contact | 8437660112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Endodontics, PC 10 E Farmfield Avenue Charleston SC 29407 Ph: (843) 766-0112 | Southeast Endodontics, PC 10 Farmfield Ave Charleston SC 29407-7756 Ph: (843) 766-0112 |
| NPI Number | 1902019722 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902019722 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 3707 (South Carolina) | Primary |
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