Provider Demographics
NPI:1841308871
Name:CAROLINA DENTAL CENTER R. JASON MEARES, DDS, PA
Entity type:Organization
Organization Name:CAROLINA DENTAL CENTER R. JASON MEARES, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:R.
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:MEARES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:843-357-2122
Mailing Address - Street 1:PO BOX 602
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-0602
Mailing Address - Country:US
Mailing Address - Phone:843-357-2122
Mailing Address - Fax:843-357-2124
Practice Address - Street 1:767 WACHESAW RD
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-5813
Practice Address - Country:US
Practice Address - Phone:843-357-2122
Practice Address - Fax:843-357-2124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC33891223G0001X
SC479-PROS1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty