Provider Demographics
NPI:1417393299
Name:J. E. CAULEY, DMD, P.C.
Entity Type:Organization
Organization Name:J. E. CAULEY, DMD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:CAULEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-744-8338
Mailing Address - Street 1:5711 RIVERS AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-6028
Mailing Address - Country:US
Mailing Address - Phone:843-744-8338
Mailing Address - Fax:843-744-9374
Practice Address - Street 1:5711 RIVERS AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-6028
Practice Address - Country:US
Practice Address - Phone:843-744-8338
Practice Address - Fax:843-744-9374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36781223G0001X
SC34051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty