Provider Demographics
NPI:1265796874
Name:CHRIS MOHLER, DDS, LLC
Entity type:Organization
Organization Name:CHRIS MOHLER, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:MOHLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:843-522-1442
Mailing Address - Street 1:200 MIDTOWN DR
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29906-5203
Mailing Address - Country:US
Mailing Address - Phone:843-522-1442
Mailing Address - Fax:843-522-2701
Practice Address - Street 1:200 MIDTOWN DR
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29906-5203
Practice Address - Country:US
Practice Address - Phone:843-522-1442
Practice Address - Fax:843-522-2701
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRIS MOHLER, DDS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3226261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental