Provider Demographics
NPI:1922499011
Name:CHAPIN ORAL AND MAXILLOFACIAL SURGERY, LLC
Entity Type:Organization
Organization Name:CHAPIN ORAL AND MAXILLOFACIAL SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:HAIRR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:803-816-2795
Mailing Address - Street 1:112 ST. PETER'S CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036
Mailing Address - Country:US
Mailing Address - Phone:803-816-2795
Mailing Address - Fax:
Practice Address - Street 1:112 ST. PETER'S CHURCH ROAD
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036
Practice Address - Country:US
Practice Address - Phone:803-816-2795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC71381223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty