Provider Demographics
NPI:1437221959
Name:DAMSKER, KJERSTI (DMD)
Entity Type:Individual
Prefix:DR
First Name:KJERSTI
Middle Name:
Last Name:DAMSKER
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 1:1745 JAMES BASFORD PLACE
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466
Mailing Address - Country:US
Mailing Address - Phone:843-814-3305
Mailing Address - Fax:
Practice Address - Street 1:1000 TANNER FORD BLVD.
Practice Address - Street 2:
Practice Address - City:HANAHAN
Practice Address - State:SC
Practice Address - Zip Code:29410
Practice Address - Country:US
Practice Address - Phone:843-818-5437
Practice Address - Fax:843-797-2559
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC40421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice