Provider Demographics
NPI:1093060626
Name:K. DARGAN FLOWERS, JR. D.M.D.
Entity Type:Organization
Organization Name:K. DARGAN FLOWERS, JR. D.M.D.
Other - Org Name:FLOWERS DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:K.
Authorized Official - Middle Name:DARGAN
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-332-0623
Mailing Address - Street 1:PO BOX 759
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29551-0759
Mailing Address - Country:US
Mailing Address - Phone:843-332-0623
Mailing Address - Fax:843-917-0454
Practice Address - Street 1:756 W CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4412
Practice Address - Country:US
Practice Address - Phone:843-332-0623
Practice Address - Fax:843-917-0454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC93871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZX2456Medicaid