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Organization
MOBILE DENTAL CARE LLC
Active
Organization
MOBILE DENTAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN E REESE DMD (CO-OWNER)
(843) 766-6194
Entity
Organization
Contact information
Practice address
1064 GARDNER RD, STE 101, CHARLESTON, SC 29407-5768
(843) 766-6194
Mailing address
1064 GARDNER RD, STE 101, CHARLESTON, SC 29407-5768
(843) 766-6194
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
SC3654
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZA9562
—
SC
Enumeration date
07/24/2007
Last updated
07/24/2007
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