| Trident General Dentistry, Douglas S Rawls, Dm | |
|
6335 Dorchester Road North Carleston SC 29418 | |
| (843) 552-2580 | |
| (843) 552-2596 |
| Full Name | Trident General Dentistry, Douglas S Rawls, Dm |
|---|---|
| Speciality | Dentist |
| Location | 6335 Dorchester Road, North Carleston, South Carolina |
| Authorized Official Name and Position | Douglas S Rawls (OWNER (SINGLE MEMBER OF LLC)) |
| Authorized Official Contact | 8435522580 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trident General Dentistry, Douglas S Rawls, Dm 6335 Dorchester Road North Carleston SC 29418 Ph: (843) 552-2580 | Trident General Dentistry, Douglas S Rawls, Dm 6335 Dorchester Road North Carleston SC 29418 Ph: (843) 552-2580 |
| NPI Number | 1437437548 |
|---|---|
| Provider Enumeration Date | 07/25/2011 |
| Last Update Date | 07/25/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437437548 | NPI | - | NPPES |
| W17307SC1 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 1823 (South Carolina) | Primary |