Provider Demographics
NPI:1891827036
Name:HESS, JOHN THOMAS (DDS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:THOMAS
Last Name:HESS
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 1:2214 W PALMETTO ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-3901
Mailing Address - Country:US
Mailing Address - Phone:843-629-8000
Mailing Address - Fax:843-629-8348
Practice Address - Street 1:2214 W PALMETTO ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-3901
Practice Address - Country:US
Practice Address - Phone:843-629-8000
Practice Address - Fax:843-629-8348
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice