| Trident Dental Associates, Llc | |
|
9228 Medical Plaza Dr Charleston SC 29406-9125 | |
| (843) 574-5693 | |
| (843) 764-4512 |
| Full Name | Trident Dental Associates, Llc |
|---|---|
| Speciality | Dentist |
| Location | 9228 Medical Plaza Dr, Charleston, South Carolina |
| Authorized Official Name and Position | William Tederick Johnson (GROUP VICE PRESIDENT/AO) |
| Authorized Official Contact | 6153723375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trident Dental Associates, Llc 2000 Health Park Dr Brentwood TN 37027-4692 Ph: (615) 373-7406 | Trident Dental Associates, Llc 9228 Medical Plaza Dr Charleston SC 29406-9125 Ph: (843) 574-5693 |
| NPI Number | 1053083154 |
|---|---|
| Provider Enumeration Date | 09/28/2021 |
| Last Update Date | 08/29/2023 |
| Medicare PECOS PAC ID | 8527458116 |
|---|---|
| Medicare Enrollment ID | O20211214002983 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053083154 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Betsy Kay Davis |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1518983857 PECOS PAC ID: 1052361441 Enrollment ID: I20050124000743 |
| Provider Name | Michelle Kathryn Ruse |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1205583481 PECOS PAC ID: 4183004419 Enrollment ID: I20240105003496 |
Mobile Dental Care Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1064 Gardner Rd, Ste 101, Charleston, SC 29407 Phone: 843-766-6194 | |
Ammons Dental By Design West Ashley Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1014 Saint Andrews Blvd Ste 210b, Charleston, SC 29407 Phone: 843-405-0990 | |
Fetter Health Care Network-downtown Site Dental Clinic Medicare: Medicare Enrolled Practice Location: 51 Nassau St, Charleston, SC 29403 Phone: 843-722-4112 Fax: 843-577-8960 | |
Dental Care Of Charlestown Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 839 Wappoo Rd, Charleston, SC 29407 Phone: 843-556-4746 Fax: 843-556-5435 | |
Charleston Periodonticspa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1051 Gardner Rd, Suite A, Charleston, SC 29407 Phone: 843-766-7131 Fax: 843-766-1839 | |
Periodontal Associates Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 33 Gamecock Ave Ste A, Charleston, SC 29407 Phone: 843-571-0853 Fax: 843-769-7342 | |
Christy M Fogle Dmd Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 776 Daniel Ellis Drive, Suite 3a, Charleston, SC 29412 Phone: 843-762-2065 Fax: 843-762-7735 |