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Organization
MATHIS FERRY DENTAL ASSOCIATES, INC.
Active
Organization
MATHIS FERRY DENTAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDNA KLATT DEPAUL DMD (OWNER)
(843) 345-2307
Entity
Organization
Contact information
Practice address
701 LEADER LN, MOUNT PLEASANT, SC 29464-8152
(843) 345-2307
(843) 881-3161
Mailing address
701 LEADER LN, MOUNT PLEASANT, SC 29464-8152
(843) 345-2307
(843) 881-3161
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
02529
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
488297
UNITED CONCORDIA
SC
05
—
ZA9806
—
SC
Enumeration date
03/21/2007
Last updated
08/08/2013
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