Provider Demographics
NPI:1649217852
Name:STILL, MERRELL CHRISTOPHER JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:MERRELL
Middle Name:CHRISTOPHER
Last Name:STILL
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10982 ELLENTON ST
Mailing Address - Street 2:
Mailing Address - City:BARNWELL
Mailing Address - State:SC
Mailing Address - Zip Code:29812-7304
Mailing Address - Country:US
Mailing Address - Phone:803-259-1124
Mailing Address - Fax:803-259-9801
Practice Address - Street 1:10982 ELLENTON ST
Practice Address - Street 2:
Practice Address - City:BARNWELL
Practice Address - State:SC
Practice Address - Zip Code:29812-7304
Practice Address - Country:US
Practice Address - Phone:803-259-1124
Practice Address - Fax:803-259-9801
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZ30229Medicaid
SCZ30229Medicaid