Provider Demographics
NPI:1013123983
Name:ELIZABETH J. BJORNSON, DDS, MHS, PA
Entity Type:Organization
Organization Name:ELIZABETH J. BJORNSON, DDS, MHS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:BJORNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MHS
Authorized Official - Phone:843-881-9909
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0352261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental