Provider Demographics
NPI:1417022914
Name:MERCER, JAMES E (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:E
Last Name:MERCER
Suffix:
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 1:7033 SAINT ANDREWS RD
Mailing Address - Street 2:SUITE102
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-1179
Mailing Address - Country:US
Mailing Address - Phone:803-781-3321
Mailing Address - Fax:803-781-4406
Practice Address - Street 1:7033 SAINT ANDREWS RD
Practice Address - Street 2:SUITE102
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-1179
Practice Address - Country:US
Practice Address - Phone:803-781-3321
Practice Address - Fax:803-781-4406
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29411223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2941OtherDENTAL LICENSE
SCZ29418Medicaid
SCQ24320Medicare UPIN
SC6917Medicare ID - Type Unspecified