Provider Demographics
NPI:1689144461
Name:RATLIFF, JOHN W (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:W
Last Name:RATLIFF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 COSGROVE AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-7644
Mailing Address - Country:US
Mailing Address - Phone:843-554-5003
Mailing Address - Fax:
Practice Address - Street 1:2320 COSGROVE AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-7644
Practice Address - Country:US
Practice Address - Phone:843-554-5003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC104481223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery