Provider Demographics
NPI:1205365657
Name:LOWCOUNTRY DENTAL ARTS, LLC
Entity Type:Organization
Organization Name:LOWCOUNTRY DENTAL ARTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:KURT
Authorized Official - Last Name:HARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-795-5652
Mailing Address - Street 1:776 DANIEL ELLIS DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-3094
Mailing Address - Country:US
Mailing Address - Phone:843-795-5652
Mailing Address - Fax:843-795-6360
Practice Address - Street 1:776 DANIEL ELLIS DRIVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412
Practice Address - Country:US
Practice Address - Phone:843-795-5652
Practice Address - Fax:843-795-6360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty