Provider Demographics
NPI:1114984994
Name:MCDUFFIE, DOCK CLEVELAND III (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOCK
Middle Name:CLEVELAND
Last Name:MCDUFFIE
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 DAVE LYLE BLVD S
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-4402
Mailing Address - Country:US
Mailing Address - Phone:803-328-0858
Mailing Address - Fax:803-324-7748
Practice Address - Street 1:427 DAVE LYLE BLVD S
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-4402
Practice Address - Country:US
Practice Address - Phone:803-328-0858
Practice Address - Fax:803-324-7748
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC34961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice