Provider Demographics
NPI:1619029071
Name:BOCKLET, RAYMOND CARY (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:CARY
Last Name:BOCKLET
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 SAVAGE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4726
Mailing Address - Country:US
Mailing Address - Phone:843-556-2133
Mailing Address - Fax:843-556-2199
Practice Address - Street 1:1845 SAVAGE RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4726
Practice Address - Country:US
Practice Address - Phone:843-556-2133
Practice Address - Fax:843-556-2199
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3154 SPECIALTY 04431223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC571027125OtherDENTAL INSURANCE
SC841807OtherMILITARY INSURANCE
SC571027125OtherDENTAL INSURANCE