Provider Demographics
NPI:1669726048
Name:DENTISTRY FOR CHILDREN OF SOUTH CAROLINA, PC
Entity type:Organization
Organization Name:DENTISTRY FOR CHILDREN OF SOUTH CAROLINA, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:REBECCA
Authorized Official - Last Name:SANDERS WARD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-818-5437
Mailing Address - Street 1:808 WAPPOO RD STE 600
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-5865
Mailing Address - Country:US
Mailing Address - Phone:843-818-5437
Mailing Address - Fax:843-725-1594
Practice Address - Street 1:808 WAPPOO RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407
Practice Address - Country:US
Practice Address - Phone:843-818-5437
Practice Address - Fax:843-725-1594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-06
Last Update Date:2018-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC32531223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty