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Organization
DENTAL CARE OF CHARLESTOWN PA
Active
Organization
DENTAL CARE OF CHARLESTOWN PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALLY THOMPSON AUSTELLA DMD (OWNER DENTIST)
(843) 556-4746
Entity
Organization
Contact information
Practice address
839 WAPPOO RD, CHARLESTON, SC 29407-5866
(843) 556-4746
(843) 556-5435
Mailing address
839 WAPPOO RD, CHARLESTON, SC 29407-5866
(843) 556-4746
(843) 556-5435
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2473
SC
Other
Enumeration date
01/03/2006
Last updated
08/22/2020
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