Provider Demographics
NPI:1346811163
Name:LOWCOUNTRY PERIODONTICS & DENTAL IMPLANTS LLC
Entity Type:Organization
Organization Name:LOWCOUNTRY PERIODONTICS & DENTAL IMPLANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:EVERETT
Authorized Official - Last Name:OPPENHEIMER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:843-842-5005
Mailing Address - Street 1:23 SHELTERCOVE LANE
Mailing Address - Street 2:BUILDING B SUITE 200
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928
Mailing Address - Country:US
Mailing Address - Phone:843-842-5005
Mailing Address - Fax:843-842-5059
Practice Address - Street 1:23 SHELTERCOVE LANE
Practice Address - Street 2:BUILDING B SUITE 200
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928
Practice Address - Country:US
Practice Address - Phone:843-842-5005
Practice Address - Fax:843-842-5005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-02
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty