Provider Demographics
NPI:1750304176
Name:BJORNSON, ELIZABETH JANE (DDS, MHS)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:JANE
Last Name:BJORNSON
Suffix:
Gender:F
Credentials:DDS, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 CHUCK DAWLEY BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7304
Mailing Address - Country:US
Mailing Address - Phone:843-881-9909
Mailing Address - Fax:843-881-8481
Practice Address - Street 1:1321 CHUCK DAWLEY BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7304
Practice Address - Country:US
Practice Address - Phone:843-881-9909
Practice Address - Fax:843-881-8481
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC03521223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics