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Organization
PLANTATION FAMILY DENTALCARE
Active
Organization
PLANTATION FAMILY DENTALCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC E RADABAUGH MBA (DIRECTOR)
(843) 364-6695
Entity
Organization
Contact information
Practice address
1859 SAVAGE RD, CHARLESTON, SC 29407-4726
(843) 722-5733
Mailing address
1859 SAVAGE RD, CHARLESTON, SC 29407-4726
(843) 722-5733
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8533
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8533
SC BOARD OF DENTISTRY
SC
Enumeration date
12/13/2016
Last updated
12/13/2016
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