NPI 1013288786

Periodontal Associates LLC

Organisation Periodontics Charleston, SC

Practice location

Address: 33 Gamecock Ave STE a, Charleston, SC 29407-3397
Phone: (843) 571-0853
Fax: (843) 769-7342

Authorised official

Name: Edward Thomas Murphy
Title: Member
Phone: (843) 571-0853

Registered specialties (3)

Periodontics Primary

Dental Providers Taxonomy 1223P0300X Licence 3981 (SC)

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Periodontics

Dental Providers Taxonomy 1223P0300X Licence 1487 (SC)

Periodontics

Dental Providers Taxonomy 1223P0300X Licence 3204 (SC)

Registry record

NPI: 1013288786
Entity type: Organization
NPI issued: 26 Jan 2012
Record last updated: 26 Jan 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.