Provider Demographics
NPI:1437313780
Name:J. NATHAN TEMPLETON, DMD, PA
Entity Type:Organization
Organization Name:J. NATHAN TEMPLETON, DMD, PA
Other - Org Name:FORT MILL DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:NATHAN
Authorized Official - Last Name:TEMPLETON
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:803-547-7508
Mailing Address - Street 1:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29716-0489
Mailing Address - Country:US
Mailing Address - Phone:803-547-7508
Mailing Address - Fax:
Practice Address - Street 1:133 CLEBOURNE ST
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-1742
Practice Address - Country:US
Practice Address - Phone:803-547-7508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC41781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty