Dr Benjamin Craig Jordan, DMD | |
737 S Main St, Society Hill, SC 29593-8972 | |
(866) 815-9845 | |
(800) 882-4690 |
Full Name | Dr Benjamin Craig Jordan |
---|---|
Gender | Male |
Speciality | Dentist - General Practice |
Location | 737 S Main St, Society Hill, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437413119 | NPI | - | NPPES |
ZX8089 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 8089 (South Carolina) | Primary |
Entity Name | Caresouth Carolina Inc. |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720082571 PECOS PAC ID: 1052221314 Enrollment ID: O20040511000280 |
Mailing Address | Practice Location Address |
---|---|
Dr Benjamin Craig Jordan, DMD Po Box 1090, Hartsville, SC 29551-1090 Ph: (843) 857-0111 | Dr Benjamin Craig Jordan, DMD 737 S Main St, Society Hill, SC 29593-8972 Ph: (866) 815-9845 |
Mae E Jesneck, DDS, LCSW Dentist Medicare: Not Enrolled in Medicare Practice Location: 737 S Main St, Society Hill, SC 29593 Phone: 843-378-3000 Fax: 843-378-9869 | |
Dr. Sean G Boynes, DMD, MS Dentist Medicare: Not Enrolled in Medicare Practice Location: 737 S Main St, Society Hill, SC 29593 Phone: 843-378-3000 Fax: 843-378-4209 | |
Dr. Heather K Kilpatrick, DMD Dentist Medicare: Medicare Enrolled Practice Location: 737 S Main St, Society Hill, SC 29593 Phone: 866-815-9845 Fax: 800-882-4690 | |
Travis Andre Russell, DDS Dentist Medicare: Medicare Enrolled Practice Location: 737 S Main St, Society Hill, SC 29593 Phone: 843-857-0111 |