Provider Demographics
NPI:1922274463
Name:CHADWELL, JOSEPH BRANDON (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:BRANDON
Last Name:CHADWELL
Suffix:
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 1:705 SQUIRES PT
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:SC
Mailing Address - Zip Code:29334
Mailing Address - Country:US
Mailing Address - Phone:864-486-1888
Mailing Address - Fax:864-486-8688
Practice Address - Street 1:705 SQUIRES PT
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:SC
Practice Address - Zip Code:29334
Practice Address - Country:US
Practice Address - Phone:864-486-1888
Practice Address - Fax:864-486-8688
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6761223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics