Provider Demographics
NPI:1194392126
Name:JEFFCOAT, MARIA CARAS (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:CARAS
Last Name:JEFFCOAT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1334 HIGHWAY 14
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-5659
Mailing Address - Country:US
Mailing Address - Phone:864-297-5585
Mailing Address - Fax:
Practice Address - Street 1:1334 HIGHWAY 14
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29681-5659
Practice Address - Country:US
Practice Address - Phone:864-297-5585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0442000423122300000X
SC104351223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0221XDental ProvidersDentistPediatric Dentistry