Provider Demographics
NPI:1740788330
Name:JOYNER FAMILY DENTISTRY LLC
Entity Type:Organization
Organization Name:JOYNER FAMILY DENTISTRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:BALFOUR
Authorized Official - Last Name:JOYNER
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-388-5168
Mailing Address - Street 1:2030 WAMBAW CRK STE 106
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29492-8382
Mailing Address - Country:US
Mailing Address - Phone:843-388-5168
Mailing Address - Fax:843-408-4077
Practice Address - Street 1:2030 WAMBAW CRK STE 106
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29492-8382
Practice Address - Country:US
Practice Address - Phone:843-388-5168
Practice Address - Fax:843-408-4077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8071261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental