Provider Demographics
NPI:1801961578
Name:CROWNS NOW DENTISTRY IRMO, INC.
Entity type:Organization
Organization Name:CROWNS NOW DENTISTRY IRMO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:R
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:864-476-8315
Mailing Address - Street 1:7241 BROAD RIVER RD
Mailing Address - Street 2:SUITE 50
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-8164
Mailing Address - Country:US
Mailing Address - Phone:803-732-3650
Mailing Address - Fax:803-732-3565
Practice Address - Street 1:7241 BROAD RIVER RD STE 50
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-8164
Practice Address - Country:US
Practice Address - Phone:803-732-3650
Practice Address - Fax:803-732-3565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC010854261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental